Patients Who Leave without Being Seen

March 1, 2013 | Health System Risk Management


Patient crowding in the emergency department (ED) not only compromises the quality of care given to patients but is costly for the organization and community. The organization loses revenue from the roughly 2% of all patients annually who leave without being seen (LWBS), and the community loses faith in its local healthcare organization. One study found that one fewer hour waited by patients in the ED equated to more than $9,000 in additional daily revenue. (Pines et al.)

From 2003 through 2009, one study found that the mean wait time in EDs increased from 46.5 minutes to 58.1 minutes. Wait times were also found to be longer in hospitals that boarded admitted patients in hallways, hospitals in urban settings, and hospitals with higher annual ED patient throughput. (Hing and Bhuiya)

Stated bluntly, the quantity of patients who leave without being seen is an “outcome-oriented measure of impaired access to emergency care and represents the failure of an emergency care delivery system to meet its goals of providing care to those most in need” (Hsia et al.). One large-scale study examined data from more than nine million ED visits and found a range of LWBS rates from 0% to 20%, with a median of 2.6%. (Hsia et al.)

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