Warwick Medical School, Coventry, UK.
Emerg Med J. 2012 Aug;29(8):617-21. doi: 10.1136/emermed-2011-200537. Epub 2011 Sep 2.
The purpose of this review was to determine the rate of those that leave the emergency department (ED) without being seen and their reasons, to clarify if such behaviour poses a health risk, to analyse the impact initiatives have made on the leave without being seen (LWBS) rate, and to discuss the implications of using it as a national performance indicator within the NHS.
A combination of data sources was reviewed: a 'realistic' literature review, analysis of hospital episode statistics data from England and a local NHS trust audit.
LWBS rates vary across the world, from 15% to 0.36%. Also initiatives to reduce LWBS rates demonstrated mixed outcomes, with reductions in the rate by as much as 96%, while others were ineffective. The most common reason quoted for LWBS was long waiting times and there were few data to suggest LWBS posed a risk to patient health.
LWBS is an issue experienced in many countries that has responded in a varying manner to many initiatives in attempts to reduce it; however, it is clearly associated with the waiting times experienced in ED and therefore working within a packet of performance measures it would assess the effect of waiting times from another perspective.
本次综述旨在确定离开急诊部（ED）而未得到诊治的患者比例及其原因，明确此类行为是否会带来健康风险，分析各项举措对未得到诊治（LWBS）率的影响，并探讨将其用作英国国家医疗服务体系（NHS）的国家绩效指标的意义。
对多种数据源进行了综合分析，包括“现实”文献综述、对英格兰医院发病统计数据的分析以及对当地 NHS 信托机构的审计。
LWBS 率在全球范围内差异显著，范围在 15%至 0.36%之间。旨在降低 LWBS 率的各项举措收效不一，其降幅高达 96%，但也有部分举措无效。LWBS 最常见的原因是长时间的等候时间，几乎没有数据表明 LWBS 会对患者健康构成风险。
LWBS 是许多国家普遍存在的问题，各国针对这一问题采取了多种举措来加以应对，但 LWBS 显然与 ED 中的等候时间有关，因此，将其纳入一系列绩效指标中，可从另一个角度评估等候时间的影响。
