title: Patients leaving the emergency department without being seen by a physician: a retrospective database analysis.
abstract: OBJECTIVE
  To describe characteristics of patients leaving the emergency department (ED) before being seen by a physician and to identify factors associated with a greater risk of leaving the ED too early.
  
  
  METHODS
  
  
  
  METHODS
  retrospective database analysis.
  
  
  METHODS
  emergency department (ED) of an urban teaching hospital admitting 60,000 patients per year.
  
  
  METHODS
  all patients older than 18 years admitted to the ED over one year. Collected data: patient's and ED visit characteristics.
  
  
  RESULTS
  Among the 57,645 patients admitted, we identified 2,413 patients (4.2%) who left without being seen (LWBS). LWBS patients were more likely to be male (odds ratio [OR] 1.13, 95% confidence interval [CI 95%]: 1.03-1.23), single (OR 1.12, CI 95%: 1.01-1.23), unemployed (OR 1.27, CI 95%: 1.13-1.44), dependent on welfare (OR 1.29, CI 95%: 1.12-1.50) or Muslim (OR 1.19, CI 95%: 1.00-1.42). LWBS patients were also more likely to present with less acute emergency triage levels. As complaints, alcohol and/or other substance abuse (OR 6.08, CI 95%: 5.04-7.34), neurological problems (OR 2.23, CI 95%: 1.88-2.64) or dermatological problems (OR 1.63, CI 95%: 1.37-1.94) were over-represented in this population. Patients admitted at week-ends (OR 1.27, 95% CI: 1.16-1.39) and/or during the night (OR = 2.67, 95% C: 2.35-3.02) also were at higher risk of leaving the ED prematurely.
  
  
  CONCLUSIONS
  LWBS patients share some characteristics and a better understanding of these characteristics as well as time and logistic issues could ease to implement strategies to reduce premature leaving from the ED.
authors: Geneva University Hospitals, SWITZERLAND; olivier.grosgurin@hcuge.ch.
authors: Olivier
authors: O
authors: Grosgurin
authors: Bérénice
authors: B
authors: Cramer
authors: Mathilde
authors: M
authors: Schaller
authors: François P
authors: FP
authors: Sarasin
authors: Olivier T
authors: OT
authors: Rutschmann
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology; D016017:Odds Ratio; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D012067:Religion; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012871:Skin Diseases / Q000453:epidemiology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors; D014218:Triage / Q000706:statistics & numerical data; D014478:Unemployment / Q000706:statistics & numerical data