29 Jan Patients Who Leave the ER Prematurely: They Are Not All the Same

MedicalResearch.com Interview with:
Jessica Moe MD, MA, PGY4 FRCPC Emergency Medicine
MSc (Candidate) Clinical Epidemiology
RCPS Emergency Medicine Residency Program
University of Alberta
Edmonton, Alberta

Medical Research: What is the background for this study? What are the main findings?

Dr. Moe: Patients who leave the emergency department (ED) prior to completing their care account for a substantial number of annual visits; some of these patients are at high medical risk. We used the National Hospital Ambulatory Medical Care Survey from 2009-2011 to examine a nationally representative sample of patients who left the ED prior to completing care.

Our work suggests that, among patients who leave the ED prematurely, the degree of medical risk may be related to whether or not these patients saw a medical professional prior to leaving the ED. Patients who leave prior to medical evaluation are generally younger and present with lower acuity visits, whereas patients who leave after medical evaluation tend to be older, are more likely to arrive by ambulance and have higher acuity visits.

Medical Research: What should clinicians take away from your report?

Dr. Moe: Clinicians should pay attention to patients who leave the emergency department prematurely – in particular, those who leave after medical evaluation are potentially sicker and may be at higher risk of future adverse events. Previous literature has shown that high rates of patients leaving prior to medical evaluation correlate with longer ED wait times, but this does not necessarily apply to the patients who leave after seeing a medical professional. Clinicians and ED administrators should also pay attention to patterns of patients leaving the ED prematurely, and try to identify reasons for which these patients leave: preventing patients from leaving prior to completing care may in some cases improve patient outcomes.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Moe: Future research should try to characterize the patient population that leaves prematurely after medical evaluation: reasons for which these patients leave have not been elucidated clearly in previous literature and our research shows that they may be a high risk group.

Citation:

Comparing Patients Who Leave the Emergency Department Prematurely, Before Versus After Medical Evaluation: A NHAMCS analysis

Moe, Jessica et al.

The American Journal of Emergency Medicine , Volume 0 , Issue 0 , in press
DOI: http://dx.doi.org/10.1016/j.ajem.2016.01.015

Jessica Moe MD, MA, PGY4 FRCPC Emergency Medicine (2016). Older, Younger Patients Leave the Emergency Room Prematurely For Different Reasons 

Last Updated on January 29, 2016 by Marie Benz MD FAAD