School of Public Health, Queensland University of Technology, Queensland, Australia.
World J Emerg Med. 2011;2(4):253-61. doi: 10.5847/wjem.j.1920-8642.2011.04.002.
Emergency departments (EDs) are critical to the management of acute illness and injury, and the provision of health system access. However, EDs have become increasingly congested due to increased demand, increased complexity of care and blocked access to ongoing care (access block). Congestion has clinical and organisational implications. This paper aims to describe the factors that appear to influence demand for ED services, and their interrelationships as the basis for further research into the role of private hospital EDs.
Multiple databases (PubMed, ProQuest, Academic Search Elite and Science Direct) and relevant journals were searched using terms related to EDs and emergency health needs. Literature pertaining to emergency department utilisation worldwide was identified, and articles selected for further examination on the basis of their relevance and significance to ED demand.
Factors influencing ED demand can be categorized into those describing the health needs of the patients, those predisposing a patient to seeking help, and those relating to policy factors such as provision of services and insurance status. This paper describes the factors influencing ED presentations, and proposes a novel conceptual map of their interrelationship.
This review has explored the factors contributing to the growing demand for ED care, the influence these factors have on ED demand, and their interrelationships depicted in the conceptual model.
急诊部（ED）对于急性疾病和损伤的管理以及获得卫生系统服务至关重要。然而，由于需求增加、护理复杂性增加以及持续护理（access block）受阻，ED 变得越来越拥堵。拥堵对临床和组织都有影响。本文旨在描述似乎影响 ED 服务需求的因素，以及它们之间的相互关系，为进一步研究私立医院 ED 的作用提供基础。
使用与 ED 和紧急健康需求相关的术语，在多个数据库（PubMed、ProQuest、Academic Search Elite 和 Science Direct）和相关期刊中进行了搜索。确定了全球范围内与急诊部利用相关的文献，并根据其与 ED 需求的相关性和重要性选择了进一步研究的文章。
影响 ED 需求的因素可以分为描述患者健康需求的因素、使患者倾向于寻求帮助的因素以及与服务提供和保险状况等政策因素相关的因素。本文描述了影响 ED 就诊的因素，并提出了它们相互关系的新概念图。
本综述探讨了导致 ED 护理需求增长的因素、这些因素对 ED 需求的影响以及概念模型中描述的它们之间的相互关系。
