Emergency department patients who leave without being seen by a doctor: the experience of a medical center in northern Taiwan.
BACKGROUND
To determine why emergency department (ED) patients leave without being seen (LWBS) by a physician and to ascertain whether they receive alternative medical care.


METHODS
A cross-sectional study was conducted of patients who left without being seen by a physician between January 1 and June 30, 1999 in a medical center ED in northern Taiwan. Medical records were reviewed for population demographics, presenting complaints, and clinic acuity rating. Follow-up telephone interviews were conducted within 3 weeks after the patient left the ED.


RESULTS
Of 74,485 registered patients, 77 (0.1%) left without being seen by a doctor, and follow-up was achieved for 39.0% (30 of 77) of these. Ninety-seven percent (75 of 77) had low acuity ratings, and 58% (45 of 77) left within 60 min after registration. The respondents cited the following 3 leading reasons for leaving: prolonged waiting times (16 of 30, 53.3%), ED appeared busy (6 of 30, 20.0%), and self-referral to the hospital outpatient department (4 of 30, 13.3%). Most respondents believed that they should have been evaluated by a physician within 60 min of presentation. About half (14/30, 46.6%) of them sought further medical care within 24 h after they left the ED.


CONCLUSIONS
In our study, only 0.1% of patients who sought care in the ED left without being seen by a physician. The majority of survey respondents had a low acuity rating and left because of long waiting times. Half of the patients who left without being seen sought alternative medical care.
Liao
How-Chin
HC
Department of Emergency Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC. cgmhpcmd@ms4.hinet.net
Liaw
Shiumn-Jen
SJ
Hu
Pai-min
PM
Lee
Keong-Tiong
KT
Chen
Chin-Ming
CM
Wang
Feng-Lin
FL
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction