Document Type
Article
Journal/Book Title/Conference
Global Health Action
Author ORCID Identifier
Uma Kelekar https://orcid.org/0000-0002-4824-5432
Debasree Das Gupta https://orcid.org/0000-0001-9854-5313
Nicole Theis-Mahon https://orcid.org/0000-0002-6913-5195
Emily Fashingbauer https://orcid.org/0009-0001-4775-8869
Boyen Huang https://orcid.org/0000-0002-1246-7447
Volume
17
Issue
1
Publisher
Taylor & Francis
Publication Date
6-3-2024
Journal Article Version
Version of Record
First Page
1
Last Page
19
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Abstract
Background
The use of Emergency Departments (EDs) for non-urgent medical conditions is a global public health concern.
Objectives
A systematic review, guided by a registered protocol (PROSPERO: CRD42023398674), was conducted to interpret the association between distance as a measure of healthcare access and the utilization of EDs for non-urgent care in high- and middle-income countries.
Methods
The search was conducted on 22 August 2023 across five databases using controlled vocabulary and natural language keywords. Eligibility criteria included studies that examined non-urgent care, and featured concepts of emergency departments, non-urgent health services and distance, reported in English. Articles and abstracts where patients were transported by ambulance/paramedic services, referred/transferred from another hospital to an ED, or those that measured distance to an ED from another health facility were excluded. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework informed the quality of evidence.
Results
Fifteen articles met the inclusion criteria. All studies demonstrated satisfactory quality with regard to study design, conduct, analysis and presentation of results. Eight (53.3%) of the studies (1 paediatric, 4 all ages/adult, 3 ecological) found a moderate level of evidence of an inverse association between distance and ED visit volume or utilization for non-urgent medical conditions, while the remaining studies reported very low or low evidence.
Conclusions
Half of the studies reported non-urgent ED use to be associated with shortest distance traveled or transportation time. This finding bears implications for healthcare policies aiming to reduce ED use for non-urgent care.
Recommended Citation
Kelekar, U., Das Gupta, D., Theis-Mahon, N., Fashingbauer, E., & Huang, B. (2024). Distances to emergency departments and non-urgent utilization of medical services: a systematic review. Global Health Action, 17(1). https://doi.org/10.1080/16549716.2024.2353994
