Advanced access in primary healthcare and its effects on emergency department utilization: a rapid review

Abstract

The advanced access (AA) scheduling model in primary healthcare (PHC) may reduce unnecessary visits to the emergency department (ED). However, evidence of this effect remains uncertain and limited. Objective: To evaluate whether the adoption of AA models in PHC may reduce ED visits, when compared to the traditional model. Methods: A rapid review of the literature according to the World Health Organization’s guidelines was performed, using two databases (PubMed and Lilacs) with articles from 1980 to 2023. Results: A total of 1286 articles were found according to our search. Of them, 1245 were excluded based on their titles, most of them due to not evaluating advanced accesses as an intervention. Of the remaining 41 articles, many did not evaluate ED visits as an outcome, nor did they have the criteria of inclusion. Eight articles evaluated ED visits as an outcome and had inclusion criteria. Five articles were included and three found an association between the adoption of advanced access in PHC and a reduction in ED visits. Conclusion: This review shows that the adoption of AA in PHC may reduce ED visits. However, it is essential to carry out new studies to understand the relationship between the adoption of AA in PHC and its outcomes in universal healthcare systems.