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Efforts to reduce such visits show mixed results, likely due to multiple caregivers and limited adaptation to local contexts. We explored factors contributing to avoidable ED visits as reported by multiple care providers, focusing on modifiable factors of importance in the design of a sustainable primary care (PC) intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting<\/jats:title>\n                    <jats:p>Web-based survey conducted across six in- and outpatient healthcare providers in Stockholm, Sweden: ED, geriatrics, ambulance services, advanced home-based healthcare, PC and home healthcare (both within and outside regular working hours). Closed-ended questions were analysed descriptively and open-ended questions using qualitative content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 100 healthcare professionals (nurse assistants, registered nurses and physicians) with at least 6\u2009months of working experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All providers considered potentially avoidable ED visits a major concern, with home care workers seen as the main initiators of ED referrals. One overarching theme was generated\u2014medical and psychosocial complexities in the assessment of older patients with multiple long-term conditions\u2014and four categories of contributing factors: (1) insufficient access to health and social care, (2) poor communication and cooperation, (3) deficient professional competence and geriatric knowledge and (4) unclear responsibility and fragmented care. Five providers highlighted limited access to care as the most demanding concern while PC noted poor communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An intervention should combine enhanced home-based care, better collaboration across providers, direct geriatric admissions and targeted training for home care workers. Accounting for differences in provider perspectives in intervention design may enhance feasibility and acceptability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-121668","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T12:40:32Z","timestamp":1786711232000},"page":"e121668","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding potentially avoidable emergency department visits in older adults: a survey with healthcare professionals across in- and outpatient care in Sweden"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3665-9275","authenticated-orcid":false,"given":"Hanna","family":"Bring","sequence":"first","affiliation":[{"name":"Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden"},{"name":"Academic Primary Care Centre, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Bergqvist","sequence":"additional","affiliation":[{"name":"Academic Primary Care Centre, Stockholm, Sweden"},{"name":"Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0063-552X","authenticated-orcid":false,"given":"Lars L","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"Karolinska University Hospital, Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anik\u00f3","family":"Veg","sequence":"additional","affiliation":[{"name":"Independent Author, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Bohm","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Swedish Red Cross University, Huddinge, Sweden"},{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5151-4867","authenticated-orcid":false,"given":"Karin","family":"Modig","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Bastholm-Rahmner","sequence":"additional","affiliation":[{"name":"Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden"},{"name":"Academic Primary Care Centre, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0446-8930","authenticated-orcid":false,"given":"Katharina","family":"Schmidt-Mende","sequence":"additional","affiliation":[{"name":"Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden"},{"name":"Academic Primary Care Centre, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"2026081405402320000_16.8.e121668.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12873-019-0236-3","article-title":"Emergency department visits in older patients: a population-based survey","volume":"19","author":"Ukkonen","year":"2019","journal-title":"BMC Emerg Med"},{"key":"2026081405402320000_16.8.e121668.2","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/ggi.13875","article-title":"Frequent emergency department use by older adults with ambulatory care sensitive conditions: A population-based cohort study","volume":"20","author":"Dufour","year":"2020","journal-title":"Geriatr Gerontol Int"},{"key":"2026081405402320000_16.8.e121668.3","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2002.121523"},{"key":"2026081405402320000_16.8.e121668.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.04.015"},{"key":"2026081405402320000_16.8.e121668.5","unstructured":"The National Board of Health and Welfare . 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