ArticleJournal of the American College of Emergency Physicians open2024
Turbulence in the system: Higher rates of left-without-being-seen emergency department visits and associations with increased risks of adverse patient outcomes since 2020.
Article in Journal of the American College of Emergency Physicians open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- Peer Support Workers to Improve Emergency Department Care Completion Among Patients Who Use Substances: A Pilot Randomized Controlled Trial.Journal of the American College of Emergency Physicians open · 2026Article
- Service use and program-level impacts of a collaborative hospital-community emergency department diversion program for people experiencing alcohol and opioid intoxication.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Early departures from the emergency department in a high-volume tertiary center: the first report from Croatia.Croatian medical journal · 2026Article
- Emergency physician burnout and attrition in Canada: a longitudinal study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Article
- Article
- When Metrics Replace Values: Ethical Concerns in Healthcare Performance Measures.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- A Machine Learning Strategy to Predict the Number of High-Acuity Children Who Leave Without Being Seen From the Emergency Department.Journal of the American College of Emergency Physicians open · 2026Article
- Article
- Left Without Being Seen: A Scoping Review of a Silent Crisis in Emergency Departments.Open access emergency medicine : OAEM · 2026Review
- Increased Time to Provider for Patients With a Non-English Language Preference: A Retrospective Cohort Study.Journal of the American College of Emergency Physicians open · 2025Article
- Operationalizing the Quintuple Aim of Health System Improvement Through Equity-Oriented Health Care.Health services insights · 2025Article
- Turbulence in the system: Higher rates of left-without-being-seen emergency department visits and associations with increased risks of adverse patient outcomes since 2020.Journal of the American College of Emergency Physicians open · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To examine risks of severe adverse patient outcomes shortly after a left-without-being-seen emergency department (LWBS ED) visit since 2020. Methods: In this retrospective study using linked administrative data, we examined temporal trends in monthly rates of ED and LWBS visits for adults in Ontario, Canada, 2014‒2023. In patient-level analyses restricted to the first eligible LWBS ED visit, we used modified Poisson regression to compare the composite outcome of 7-day all-cause mortality or hospitalization following a LWBS ED visit for April 1, 2022‒March 31, 2023 (recent period) to April 1, 2014‒March 31, 2020 (baseline period), adjusted for age, sex, and Charlson comorbidity index. Results: Despite fewer monthly ED visits since 2020, temporal trends revealed sustained increases in monthly LWBS rates. LWBS ED visits after April 1, 2020 exceeded the baseline period's single-month LWBS maximum of 4.0% in 15 out of 36 months. The composite outcome of 7-day all-cause mortality or hospitalization was 3.4% in the recent period versus 2.9% in the baseline period (adjusted risk ratio [aRR] 1.14, 95% confidence interval [CI] 1.11‒1.18) and remained elevated at 30 days (6.2% vs. 5.8%, respectively; aRR 1.05, 95% CI 1.03‒1.07), despite similar rates of post-ED outpatient visits (7-day recent and baseline: 38.9% and 39.7%, respectively, Conclusions: The rate of short-term mortality or hospitalization after a LWBS ED visit has recently increased, despite fewer ED visits/month and similar proportion of post-ED outpatient encounters. This concerning signal should prompt interventions to address system- and population-level causes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.