Emergency department models of care in the context of care quality and cost: A systematic review

Wylie, Kate, Crilly, Julia, Toloo, Ghasem Sam, FitzGerald, Gerry, Burke, John, Williams, Ged, & Bell, Anthony (2015) Emergency department models of care in the context of care quality and cost: A systematic review. Emergency Medicine Australasia, 27(2), pp. 95-101.

View at publisher


To identify current ED models of care and their impact on care quality, care effectiveness, and cost. A systematic search of key health databases (Medline, CINAHL, Cochrane, EMbase) was conducted to identify literature on ED models of care. Additionally, a focused review of the contents of 11 international and national emergency medicine, nursing and health economic journals (published between 2010 and 2013) was undertaken with snowball identification of references of the most recent and relevant papers. Articles published between 1998 and 2013 in the English language were included for initial review by three of the authors. Studies in underdeveloped countries and not addressing the objectives of the present study were excluded. Relevant details were extracted from the retrieved literature, and analysed for relevance and impact. The literature was synthesised around the study's main themes. Models described within the literature mainly focused on addressing issues at the input, throughput or output stages of ED care delivery. Models often varied to account for site specific characteristics (e.g. onsite inpatient units) or to suit staffing profiles (e.g. extended scope physiotherapist), ED geographical location (e.g. metropolitan or rural site), and patient demographic profile (e.g. paediatrics, older persons, ethnicity). Only a few studies conducted cost-effectiveness analysis of service models. Although various models of delivering emergency healthcare exist, further research is required in order to make accurate and reliable assessments of their safety, clinical effectiveness and cost-effectiveness.

Impact and interest:

2 citations in Scopus
Search Google Scholar™
2 citations in Web of Science®

Citation counts are sourced monthly from Scopus and Web of Science® citation databases.

These databases contain citations from different subsets of available publications and different time periods and thus the citation count from each is usually different. Some works are not in either database and no count is displayed. Scopus includes citations from articles published in 1996 onwards, and Web of Science® generally from 1980 onwards.

Citations counts from the Google Scholar™ indexing service can be viewed at the linked Google Scholar™ search.

Full-text downloads:

8 since deposited on 13 Apr 2015
7 in the past twelve months

Full-text downloads displays the total number of times this work’s files (e.g., a PDF) have been downloaded from QUT ePrints as well as the number of downloads in the previous 365 days. The count includes downloads for all files if a work has more than one.

ID Code: 83498
Item Type: Journal Article
Refereed: Yes
Keywords: cost, emergency department, models of care, quality
DOI: 10.1111/1742-6723.12367
ISSN: 1742-6723
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Health Care Administration (111709)
Australian and New Zealand Standard Research Classification > ECONOMICS (140000) > APPLIED ECONOMICS (140200) > Health Economics (140208)
Australian and New Zealand Standard Research Classification > STUDIES IN HUMAN SOCIETY (160000) > POLICY AND ADMINISTRATION (160500) > Health Policy (160508)
Divisions: Current > Research Centres > Centre for Emergency & Disaster Management
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
  • QEMRF/EMPJ-12-185-Bell-Swamped
Copyright Owner: Copyright 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
Deposited On: 13 Apr 2015 22:56
Last Modified: 16 May 2016 04:55

Export: EndNote | Dublin Core | BibTeX

Repository Staff Only: item control page