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Findings from an Australian study suggest that measures are needed to stop patients leaving hospital emergency departments (EDs) without seeing a doctor, after estimating that about half of them warranted an examination, some of whom may not have other options for obtaining health care. This is the first large scale study in Australia to ascertain how such patients fare, assessing over 450 patients.
Most likely to walk out were patients with a “potentially serious” problem or a “less urgent” problem. Nevertheless, almost two thirds of those who left contacted other health agencies during the following week: 57% visited general practitioners, who triaged a quarter as having potentially life threatening disease. In all, 13% of all patients who walked out revisited EDs within seven days afterwards, and 5% were admitted; 8% accessed no services during this time.
Determining such patients' exact needs might permit service improvements to reduce walkouts, the researchers think. Their data already show that those who leave after triage are typically young (<30 years), parents with young children, and are dissatisfied with waiting time. Overcrowding in the department and night time attendance were also linked to walking out, as elsewhere.
The study attempted to follow up by telephone 1272 patients identified from 14741patient registrations as walking out of one ED in a teaching hospital in Sydney during four months in 2003.
Only a few studies have tried to ascertain what happens to patients who walk out of EDs—an important basis for assessing healthcare delivery and future planning.
Mohsin M, et al. Emergency Medicine Journal 2007;24:175–179.
Please visit the Quality and Safety in Health Care website [www. qshc.com] for a link to the full text of this article.