title: Demand for hospital emergency departments: a conceptual understanding.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Public Health, Queensland University of Technology, Queensland, Australia.
authors.forename: Jun
authors.initials: J
authors.lastname: He
authors.affiliation: School of Public Health, Queensland University of Technology, Queensland, Australia.
authors.forename: Xiang-Yu
authors.initials: XY
authors.lastname: Hou
authors.affiliation: School of Public Health, Queensland University of Technology, Queensland, Australia.
authors.forename: Sam
authors.initials: S
authors.lastname: Toloo
authors.affiliation: School of Public Health, Queensland University of Technology, Queensland, Australia.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Patrick
authors.affiliation: School of Public Health, Queensland University of Technology, Queensland, Australia.
authors.forename: Gerry
authors.initials: G
authors.lastname: Fitz Gerald
keywords: Crowding; Demand; Emergency department; Emergency medicine; Emergency room; Emergency services; Risk factors