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. 2024 Dec 7;16(12):e75277.
doi: 10.7759/cureus.75277. eCollection 2024 Dec.

Factors Associated With Leaving-Without-Being-Seen in Pediatric Emergency Department Patients

Takashi Nihira  1   2 , Takateru Ihara  1   3 , Yuta Sasaoka  1   4 , Yusuke Hagiwara  1
Affiliations

Factors Associated With Leaving-Without-Being-Seen in Pediatric Emergency Department Patients

Takashi Nihira et al. Cureus. .

Abstract

Aim Preventing leaving-without-being-seen (LWBS) in children is crucial due to their inability to seek medical care independently. Because there are no studies of LWBS in Japan, the extent of this problem in Japan and its impacts on healthcare are uncertain. The present study seeks to fill this gap by investigating LWBS after triage and identifying the associated factors. Methods The present, retrospective cohort study was conducted using an electronic, administrative database at a tertiary pediatric medical center in Japan. All records of children aged 15 years or less presenting to the emergency department between April 1, 2014 and March 31, 2017 were included, and the factors associated with LWBS were analyzed. Results During the study period, 112,059 patients were registered, of whom 168 (0.15%) were identified as having LWBS. Several factors were associated with LWBS, including less urgent acuity (odds ratio [OR]: 2.33) and visits on weekends/holidays (OR: 1.71) and evenings (OR: 1.44). Increased emergency department length of stay (EDLOS) and wait time were also associated with increased LWBS (OR: 3.48 for EDLOS > one hour; OR: 41.93 for waiting time > one hour). Conclusion Low acuity; visits on weekends/holidays, and evenings; EDLOS of more than one hour; and waiting time of more than one hour were associated with LWBS. These findings were in line with those of previous studies conducted in other countries, suggesting that they might be highly generalizable.

Keywords: acuity; emergency services; leaving-without-being-seen; triage; waiting time.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Tokyo Metropolitan Children’s Medical Center's Institutional Review Board issued approval no. 2019b-101. Information about this study was disclosed on the institutional website with an opt-out clause. The data of any patient who declined participation were excluded from this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Definition of the time categories.
In the LWBS group, waiting time was identical with EDLOS. EDLOS, emergency department length of stay; LWBS, leaving-without-being-seen.
Figure 2
Figure 2. Patient flow diagram.
EDLOS, emergency department length of stay; LWBS, leaving-without-being-seen.
See this image and copyright information in PMC

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