A mixed method systematic review of the reasons parents attend emergency department with their children for non-urgent conditions.

Background: Non-urgent visits to emergency department (ED) services is on the increase, and the pressure on EDs is a significant global concern. The use of EDs by parents of children with non-urgent condition is an important and still unresolved problem, which is associated with overcrowding, higher costs, lower quality of care and longer waiting times. The aim of this review is to identify parental reasons for visiting ED for children presenting with non-urgent conditions.
Method: Seven databases were systematically searched in August 2016. The study selection process and quality assessment were undertaken independently by two authors. Data were analysed by means of narrative synthesis.
Results: Twenty-two studies met with pre-specified inclusion criteria. Ten studies used quantitative methods, ten studies used qualitative methods, and a further two studies used mixed methods. All included studies were conducted in high-income countries and reported in English. Identified themes included perceived urgency by parents, perception regarding better care and staff expertise in the ED, proximity, out of hours availability, difficulties with obtaining a GP appointment, GP referral, lack of facilities in primary healthcare services, financial issues, need for reassurance, convenience and access issues.
Conclusion: This review brings both qualitative and quantitative data together. This review may inform researchers, healthcare staff and healthcare policy makers in better understanding parental reasons for using the ED. Identifying parental reasons may help with the development of targeted interventions that seek to reduce non-urgent ED visits, which would save overstretched healthcare resources.