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What older people want from emergency care: a systematic review
  1. James David van Oppen1,2,
  2. Lisa Keillor2,
  3. Áine Mitchell2,
  4. Timothy John Coats2,3,
  5. Simon Paul Conroy1
  1. 1Department of Health Sciences, University of Leicester, Leicester, UK
  2. 2Emergency Department, University Hospitals of Leicester NHS Trust, Leicester, UK
  3. 3Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
  1. Correspondence to Dr James David van Oppen, Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK; jvo3{at}


Objectives To evaluate the expectations and preferred outcomes from emergency care among older people or their caregivers.

Methods A review protocol was registered. Medline, Embase, CINAHL, PsychInfo, BNI, AgeInfo and the Cochrane Database of Systematic Reviews were searched in their full date ranges to September 2018. Included articles were hand-searched for further citations. Citations were screened for (1) older people aged over 65 years, (2) ED settings and (3) reporting expectations or preferred outcomes for emergency care (as opposed to experience or satisfaction). Quality appraisal and data extraction of eligible articles were undertaken by two reviewers. Themes were synthesised through content analysis and described narratively.

Results Older people wished to have prompt waiting times, efficient care, clear communication and comfortable environments. They had additional and unique expectations for holistic care and support in decision-making. The ED provoked a sense of vulnerability among older people who were likely to have had frailty.

Conclusion The lack of dominant themes among included studies suggests that older people should be treated as individuals rather than a homogenous group. Establishing individuals’ preferred outcomes could improve person-centred care.

PROSPERO registration number CRD42018107050.

  • emergency department
  • aged
  • geriatrics
  • frailty
  • quality

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  • Twitter @J_vanOppen

  • Contributors JDvO and SPC planned the review. JDvO, LK and AM extracted and analysed data. All authors contributed to the narrative synthesis and manuscript drafting.

  • Funding JDvO was supported by an NIHR Academic Clinical Fellowship. LK and AM were Geriatric Emergency Medicine Fellows at University Hospitals of Leicester NHS Trust.

  • Disclaimer The funders had no role in this review.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.