title: Reasons military patients with primary care access leave an emergency department waiting room before seeing a provider.
abstract: OBJECTIVE
  Our objective was to assess patients' understanding of emergency department (ED) wait times and why patients may leave the waiting room before seeing a provider.
  
  
  METHODS
  Survey of patients in the ED waiting room of an urban tertiary care military hospital where civilian and military patients are treated.
  
  
  RESULTS
  A total of 508/517 surveys (98%) were completed. Age ranges were 18 to 35 years (49%), 36 to 60 (31%), or older than 60 (20%). Education levels were high school (20%), some college (37%), or college graduate (39%). Of 503 respondents, 125 (25%) had left an ED waiting room before seeing a provider. The reasons included excessive wait times (91%) and family responsibilities (5%). Five hundred eight reported the factors that would motivate them to wait to see the physician (not leave without being seen [LWOBS]) were the severity of illness (64%), and if they received an update of wait times (26%); 82% (391/480) understood that severely ill patients were seen first. Patients attributed long wait times to doctors and nurses caring for other patients (292/583, 50%) and insufficient physician and nurse staffing (245, 42%). Of 802 responses for ideas to improve the wait, 34% said regular updates on estimated wait times, 21% said television shows or movies to view, 20% said books and magazines to read, and 11% said computers to access.
  
  
  CONCLUSIONS
  Long wait times were the primary reason that patients left before seeing a provider, despite having ready access to care. Respondents attributed long wait times to patient volume and inadequate staffing. Regular updates on wait times and material for entertainment may improve the waiting experience and reduce LWOBS.
authors.affiliation: Department of Emergency Medicine, San Antonio Military Medical Center; and Department of Emergency Medicine, Wilford Hall Medical Center, San Antonio, TX 78234, USA. smvarney@gmail.com
authors.forename: Shawn M
authors.initials: SM
authors.lastname: Varney
authors.forename: Toni E
authors.initials: TE
authors.lastname: Vargas
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Pitotti
authors.forename: Vikhyat S
authors.initials: VS
authors.lastname: Bebarta
mesh_terms: D000293:Adolescent; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006772:Hospitals, Military / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D063128:Tertiary Health Care / Q000706:statistics & numerical data; D013997:Time Factors; D014850:Waiting Lists; D055815:Young Adult