Mohsin Mohammed, Young Lis, Ieraci Sue, Bauman Adrian E
Centre for Research, Evidence Management and Surveillance, Division of Population Health, Sydney South West Area Health Service, Liverpool BC, New South Wales, Australia.
Emerg Med Australas. 2005 Oct-Dec;17(5-6):434-42. doi: 10.1111/j.1742-6723.2005.00774.x.
To explore the association between daily patient numbers, sociodemographic, clinical and system characteristics and walkout rates of patients from New South Wales (NSW) public hospital ED (without seeing a medical officer).
This was a secondary analysis of the NSW Emergency Department Data Collection, between 1 January 1999 and 31 December 2001, with a total of 4 356 323 ED attendances. Bivariate and multiple logistic regression analyses were performed to explore the relationship of walkout from ED and explanatory variables.
About 5.7% of the patients attending in NSW public hospital ED left without seeing a doctor. The results from bivariate and multivariate analyses revealed that walkout rates significantly varied by sociodemographic and clinical characteristics of the patients. Patient groups that more likely to walk out were those aged 15-44 years, from a non-English-speaking background, Aboriginal, with lower socioeconomic status, with no private health insurance coverage and longer waiting times for triage. Patient volume in the ED showed a significant positive association with walkout rates.
After adjusting for triage category (urgency of presentation) and triage time, patients from lower socioeconomic backgrounds and those without private health insurance coverage were more likely to leave ED without treatment. These results have important implications for Health Services. Future strategies aimed at minimizing walkouts from public hospital ED should prioritize and target factors identified in the present study.
探讨新南威尔士州（NSW）公立医院急诊科（未见到医务人员）每日患者数量、社会人口统计学、临床及系统特征与患者自行离开率之间的关联。
这是对1999年1月1日至2001年12月31日期间新南威尔士州急诊科数据收集的二次分析，共有4356323人次急诊科就诊记录。进行了双变量和多因素逻辑回归分析，以探讨急诊科自行离开与解释变量之间的关系。
新南威尔士州公立医院急诊科约5.7%的就诊患者未看病就离开了。双变量和多变量分析结果显示，自行离开率因患者的社会人口统计学和临床特征而有显著差异。更有可能自行离开的患者群体包括15至44岁、非英语背景、原住民、社会经济地位较低、没有私人医疗保险且分诊等待时间较长的人群。急诊科的患者数量与自行离开率呈显著正相关。
在调整分诊类别（就诊紧急程度）和分诊时间后，社会经济背景较低且没有私人医疗保险的患者更有可能未经治疗就离开急诊科。这些结果对卫生服务具有重要意义。未来旨在尽量减少公立医院急诊科患者自行离开的策略应优先考虑并针对本研究中确定的因素。
