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Children Who Leave the Emergency Department Without Being Seen: Why Did They Leave and What Would Make Them Stay?

Rodrigo Sousa1, Cátia Correia2, Rita Valsassina3

  • 1Departamento de Pediatria. Hospital Beatriz Ângelo. Loures.

Acta Medica Portuguesa
|March 30, 2018
PubMed

Insights

Excessive waiting times in emergency departments cause children to leave without being seen. However, most children who leave do not experience adverse outcomes, suggesting low-acuity cases.

Area of Science:

  • Pediatric Emergency Medicine
  • Healthcare Access and Quality

Background:

  • Children leaving emergency departments without being seen (LWBS) is a complex issue.
  • Understanding the reasons and outcomes for LWBS is crucial for improving pediatric emergency care.

Purpose of the Study:

  • To compare sociodemographic characteristics of children who left without being seen versus those who did not.
  • To evaluate parental reasoning, subsequent medical care utilization, and patient outcomes for LWBS cases.

Main Methods:

  • Prospective case-control study design.
  • Random sampling of LWBS children and matched controls from an emergency department over three months.
  • Phone questionnaire to gather data on reasons for leaving, outcomes, and feedback.

Main Results:

  • 0.5% of pediatric emergency department patients (92/18,200) left without being seen.
  • Primary reasons for leaving were excessive waiting time (92.7%) and the problem could wait (21.8%).
  • LWBS patients were significantly more likely to seek further medical care (78.2% vs. 11%) but did not have worse outcomes.

Conclusions:

  • Excessive waiting time is the main driver for pediatric LWBS.
  • Low rates of adverse outcomes suggest many LWBS patients present with low-acuity conditions.
  • Strategies to reduce waiting times may decrease LWBS rates, and concerns about clinical outcomes may be overstated.
Abstract

Keywords:
ChildEmergency Service, HospitalOutcome Assessment (Health Care)Patient Acceptance of Health CarePatient DropoutsPortugalWaiting Lists

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