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

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.