Characteristics of patients leaving the emergency department without being seen by a doctor: The first report from Türkiye

Abstract

The presence of patients who leave without being seen (LWBS) by a physician in the emergency department (ED) is an essential indicator of the accessibility and quality of healthcare delivery. A high LWBS rate implies low patient satisfaction. This study aims to analyze the prevalence and characteristics of LWBS patients in Türkiye and their ED readmission rate within 3 days. This retrospective, single-center, observational study was conducted in the ED of a Turkish tertiary university hospital. It looked at patients who left without being evaluated by a physician admitted to the ED between June 01, 2021, and June 01, 2023. Data on age, gender, residential area, health insurance status, ED readmission within 3 days, complaints, and hospitalization were obtained through the hospital's electronic record system. The prevalence of LWBS patients was 0.43%. Only 0.6% (n = 5) of LWBS patients had no health insurance. About 12.8% (n = 99) of them were 65 years and older. About 10.2% (n = 79) of LWBS patients were readmitted to the ED within 72 hours. The most common reason for readmission was musculoskeletal system complaints. Statistically, ED readmission was significantly more common in older adults (P = .05). Older LWBS patients are more likely hospitalized upon return visits to the ED (P = .014). LWBS patients are both a result and a consequence of ED crowding. A zero LWBS rate is crucial for older adults' health as they may fall victim to an invisible accident while avoiding ED traffic. Prioritizing older adults and reorganizing waiting areas can reduce ED crowding and cost burden due to delayed treatments.