Why I Left the Emergency Department Before Receiving Care (Did Not Wait): A Cross-Sectional Study

Understanding the factors that lead patients to leave the Emergency Department (ED) before treatment begins, and their subsequent health-seeking behaviours, is essential. This study explores the patient perspective on decisions not to wait (DNW) and documents patterns of care utilisation after leaving the ED.

This study employed a cross-sectional survey that was specifically designed and tested for this research. The survey was distributed to patients via an automated messaging platform-MessageMedia linked to a REDCap database. During 5 months of data collection there were 37,303 patients' presentations to the ED of which 1282 participants of all ages were identified within the DNW cohort who were invited to participate in a follow-up survey which yielded 246 responses, 41 of whom were under the age of 18 years.

Participants had a mean age of 44.3 years (SD = 19.4), spent an average of 207.3 min (SD = 145.5) in the ED and the majority were female (67.1%). Receiving advice on what to do if their condition worsened was significantly associated with the length of time participants were prepared to wait (χ² (2) = 8.97, p = 0.011). Among those who received advice, 59.6% left due to long waits compared with 73.2% of those who did not receive such advice and 53.8% were either triage category 2 or 3 indicating that more than half of the participants were acutely unwell.

Providing clinical advice and waiting time estimates may help reduce the rate of DNW given its significance in patient safety.