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Patients who leave without being seen.

M P Weissberg, M Heitner, S R Lowenstein

    Annals of Emergency Medicine
    |July 1, 1986
    PubMed
    Summary
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    Patients leaving the emergency department without being seen (LWBS) often experience acute psychological distress. This distress, not waiting times or chief complaints, is linked to patients leaving before receiving medical care.

    Area of Science:

    • Emergency Medicine
    • Psychiatry
    • Health Services Research

    Background:

    • Understanding patient flow and reasons for departure from emergency departments (EDs) is crucial for healthcare system optimization.
    • A significant number of patients leave EDs without completing treatment, a phenomenon known as leaving without being seen (LWBS).
    • Limited research exists on the specific characteristics and motivations of patients who leave without being seen.

    Purpose of the Study:

    • To investigate the characteristics of patients who leave emergency departments without being seen.
    • To identify factors associated with the decision of patients to leave before receiving medical attention.
    • To compare patients who leave without being seen (LWBS) to those who complete their ED visit.

    Main Methods:

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  • A prospective study was conducted in an emergency department over a six-week period.
  • Data were collected on 4,868 registered patients, with 68 identified as LWBS.
  • A matched comparison group of non-LWBS patients was selected for follow-up interviews.

    • Main Results:

    • Of 68 LWBS patients, 97% left before physician assessment.
    • LWBS and non-LWBS patients did not differ in waiting times or chief complaint types.
    • A significantly higher proportion of LWBS patients (22/30) reported acute psychological distress compared to the control group (1/14).

    Conclusions:

    • Acute psychological distress is a primary driver for patients leaving the emergency department without being seen.
    • Factors contributing to distress included recent bereavements, alcoholism, financial issues, suicidal ideation, and social crises.
    • Addressing psychological and social needs may reduce LWBS rates in emergency departments.