The Transition of Care Between Emergency Department and Primary Care: An Integrative Systematic Review.
Kathleen Hain, Jennie M Scarvell, Catherine Paterson
PMID 39334564WHAT IT FOUND
Many patients struggled to get primary care after emergency department discharge because of cost, insurance, appointment access, unclear instructions and poor communication.
Having insurance, a regular primary care provider and clear discharge support helped follow-up.
Key findings
01Reported primary-care follow-up after emergency department discharge varied widely, from 31% to 89.7% across included studies.
02Older patients often left the emergency department without understanding their diagnosis, expected illness course, contingency plan or how to follow up with primary care.
03Health insurance and having a regular primary care provider were associated with better follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included studies of varying methodological quality, and no study was excluded based on individual quality scores. Many included studies used convenience sampling and relied on patient-reported follow-up, which may be affected by social desirability and recall bias. Only English-language publications were searched, so relevant studies in other languages may have been missed. Nineteen studies were single-centre, all included studies except two were conducted in urban hospitals, and no study was solely rural. Some included studies were not patient focused; they involved healthcare professionals or hypothetical patient scenarios.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that any single emergency department intervention will reliably improve follow-up. The review combined heterogeneous studies, many used multicomponent interventions or self-reported follow-up, and it did not isolate which components caused improvement.