Just Accepted

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Patients’ reasons for leaving an Emergency Department without being seen; Results from a survey-based cohort study during the COVID-19 pandemic

Irene Bryan , Anthony Austen-Wishart, Pratibha Ranjan, Luke Plant, Dana Forcey, Robert Millar

Abstract

Objective: Patients who do not wait (DNW) to be seen are a problem for Emergency Department (ED) care. This study aimed to identify the rate and reasons patients DNW during one month of the COVID-19 pandemic. Methods: An observational cohort study of DNW patients presenting to Austin Health ED in August 2021. Patients were identified using hospital coding data and surveyed by telephone. Patients’ reasons for DNW were explored, and their demographics and clinical outcomes compared to those who received care. Results: Of 7,641 patients presenting to ED in the study period, 6% (n=452) DNW. Compared with those who received care, DNW patients were younger (p<0.001), had lower triage categories (p=0.001) and were more likely to have self-presented (p=0.006). 47% of DNW patients (n=213) participated in the survey. Reasons for leaving included waiting time (61%, n=129), symptom improvement (13%, n=28), reassurance from staff (7%, n=15) and ED crowding (6%, n=12). 75% of DNW patients (n=159) sought alternative medical care. 14% (n=29) reported hospitalisation within 7 days. 64% (n=137) did not feel the experience impacted their likelihood of seeking future ED care; 32% (n=69) felt less likely to seek future ED care. Conclusions: During the month studied, the DNW rate was 6%. Reassuringly, most patients sought alternative medical care, though a third were dissuaded from returning to ED. Future research should focus on high-risk group delineation and qualitatively describing experiences and reasons for DNW.

AH24285  Accepted 06 December 2024

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