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Why I Left the Emergency Department Before Receiving Care (Did Not Wait): A Cross-Sectional Study.
Abdi D Osman1,2,3, Jahar Bhowmik4, Robert Millar1,2
1Emergency Department, Austin Health, Melbourne, Victoria, Australia.
Emergency Medicine Australasia : EMA
|January 7, 2026
Summary
Patients leaving the Emergency Department (ED) before treatment, known as decisions not to wait (DNW), may be reduced by providing clinical advice and estimated waiting times. Understanding these patient behaviors is crucial for improving ED care.
Area of Science:
- Emergency Medicine
- Patient Behavior Studies
- Healthcare Management
Background:
- Understanding why patients leave the Emergency Department (ED) before receiving treatment is crucial for improving patient safety and care.
- Subsequent health-seeking behaviors after leaving the ED require further investigation.
Purpose of the Study:
- To explore patient perspectives on decisions not to wait (DNW) in the ED.
- To document patterns of care utilization among patients who leave the ED without treatment.
Main Methods:
- A cross-sectional survey was designed and administered via an automated messaging platform linked to a REDCap database.
- Data were collected over 5 months from 37,303 ED presentations, with 246 responses from the DNW cohort.
Main Results:
- The study included 246 participants with a mean age of 44.3 years; 67.1% were female.
- Receiving advice on worsening conditions was linked to willingness to wait (p=0.011).
- Over half of participants (53.8%) were triage category 2 or 3, indicating acute illness.
Conclusions:
- Providing clinical advice and waiting time estimates could potentially decrease the rate of patients leaving the ED before treatment.
- Addressing patient concerns about wait times is vital for enhancing ED safety and patient flow.
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