Hospital Determinants of Emergency Department Left Without Being Seen Rates

When a person goes to the hospital emergency department (ED) and leaves without being seen, the emergency care delivery system has failed to meet its goal to provide care to those most in need.

These researchers examined 9.2 million ED visits to 262 California hospitals in 2007 to determine whether hospital socioeconomic status case mix or hospital structural characteristics predicted left without being seen rates.

The percentage of left without being seen ranged from 0 percent to 20.3 percent with a median of 2.6 percent.

Hospital Patient Socioeconomic Status Case Mix: High-income patients and higher operating margin hospitals were associated with a lower probability of a person leaving without being seen. Hospitals having greater proportions of minority patients and Medi-Cal or uninsured patients were associated with a higher probability of left without being seen.

Hospital Structural Characteristics: Teaching hospitals, county-owned hospitals and trauma centers were associated with a higher probability of left without being seen than non-teaching, non-county-owned and non-trauma centers.

These large variations suggest that there is great room to improve left without being seen rates. Regional interventions for targeted hospitals could improve access to emergency care and health outcomes.