aTEREM Emergency Medical Centers, Jerusalem, Israel bSt Mark's Family Medicine, Salt Lake City, Utah cYeshiva University-Stern College, New York, New York dUniversity of Alabama Medical School, Mountain Brook, Alabama, USA.
Eur J Emerg Med. 2013 Dec;20(6):420-4. doi: 10.1097/MEJ.0b013e328359167e.
This study attempts to quantify and characterize the patients who leave before being seen (LBBS) by a physician in an urgent care setting.
A retrospective chart review was performed of visits between 1 May 2008 and 31 March 2010, at five urgent care centers (UCC). Variables extracted included sex, age, date and time of visit, and the chief complaint. A log of patient reports of the reasons for LBBS was reviewed. The relationship between waiting times and LBBS was analyzed for visits between 1 April 2012 and 30 June 2012.
LBBS visits comprised 2.0% of the total of 378 332 visits. The left-before-being-seen group had a higher percentage of men (P<0.0001), and young and middle-aged patients (P<0.0001). The left-before-being-seen group had more visits in the overnight and daytime shifts and fewer visits on weekends (P<0.0001). Of those 10 409 patients who reported reasons at discharge, 43% cited a long wait time and 39% did not want to pay the copay. In the group for which wait times were available, 92.3% were triaged within 30 min and yet 60% of those who gave reasons stated that they were leaving because they had waited too long.
The rates of leaving before being seen in urgent care were comparable with the lower end of those reported by emergency departments. Patients who left before being seen in UCC were most likely to be working-age adults during daytime hours. In UCC, LBBS is often related to perceived, rather than actual, long wait times.
本研究试图量化和描述在急诊就诊前离开(LBBS)的患者特征。
对 2008 年 5 月 1 日至 2010 年 3 月 31 日期间,在五个急诊护理中心(UCC)就诊的情况进行了回顾性图表审查。提取的变量包括性别、年龄、就诊日期和时间以及主要诉求。回顾了患者报告 LBBS 原因的日志。分析了 2012 年 4 月 1 日至 6 月 30 日期间就诊的患者等待时间与 LBBS 之间的关系。
LBBS 就诊占 378332 次就诊的 2.0%。LBBS 组中男性比例较高(P<0.0001),且年轻和中年患者比例较高(P<0.0001)。LBBS 组夜间和日间班次的就诊次数较多,周末就诊次数较少(P<0.0001)。在 10409 名报告出院原因的患者中,43%表示等待时间长,39%表示不想支付共付额。在可获得等待时间的组中,92.3%在 30 分钟内分诊,但 60%给出原因的患者表示他们离开是因为等待时间过长。
在急诊就诊前离开的比率与急诊部门报告的下限相当。在 UCC 就诊前离开的患者最有可能是白天工作年龄的成年人。在 UCC 中,LBBS 通常与感知到的而不是实际的长等待时间有关。