{"id":20845,"date":"2024-12-18T10:25:40","date_gmt":"2024-12-18T15:25:40","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=news_release&#038;p=20845"},"modified":"2024-12-19T10:27:53","modified_gmt":"2024-12-19T15:27:53","slug":"patients-who-leave-the-emergency-department-without-being-seen-face-higher-risk-of-death-hospitalization","status":"publish","type":"news_release","link":"https:\/\/www.ices.on.ca\/fr\/news-releases\/patients-who-leave-the-emergency-department-without-being-seen-face-higher-risk-of-death-hospitalization\/","title":{"rendered":"Patients who leave the emergency department without being seen face higher risk of death, hospitalization"},"content":{"rendered":"<p><b><span data-contrast=\"none\">Toronto, ON, December 18, 2024<\/span><\/b><span data-contrast=\"none\"> \u2013 Since 2020, more Ontario adults are leaving the emergency department without being seen and they face a 14% higher risk of death or hospitalization within seven days, <span class=\"TextRun SCXW136870820 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW136870820 BCX8\" data-ccp-charstyle=\"normaltextrun\">according to <\/span><\/span><a class=\"Hyperlink SCXW136870820 BCX8\" href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1002\/emp2.13299\" target=\"_blank\" rel=\"noreferrer noopener\"><span class=\"TextRun Underlined SCXW136870820 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW136870820 BCX8\" data-ccp-charstyle=\"Hyperlink\">a new study<\/span><\/span><\/a><span class=\"TextRun SCXW136870820 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW136870820 BCX8\" data-ccp-charstyle=\"normaltextrun\"> from <\/span><\/span><strong><span class=\"TextRun SCXW136870820 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW136870820 BCX8\" data-ccp-charstyle=\"normaltextrun\">ICES<\/span><\/span><\/strong><span class=\"TextRun SCXW136870820 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW136870820 BCX8\" data-ccp-charstyle=\"normaltextrun\">.<\/span><\/span><\/span><\/p>\n<p><span data-contrast=\"none\">The researchers also found that the increased risk of death or hospitalization persisted through to 30 days after the emergency department (ED) visit, though the risk fell to 5%. This finding comes despite fewer monthly ED visits since 2020 compared to the pre-pandemic period (2014-2020).<\/span><span data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">\u201cThere are many reasons why people choose to leave the emergency department, but it\u2019s usually about wait times,\u201d says lead author Dr. Candace McNaughton, an emergency medicine physician and scientist at ICES and Sunnybrook Health Sciences Centre.\u00a0<\/span><span data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">\u201cThere&rsquo;s an assumption made that if people leave the ED before being seen, they\u2019re well enough to go and they will probably be fine. But our findings paint a different picture,\u201d she says.<\/span><span data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">Leaving Without Being Seen (LWBS) Rates Higher Post-Pandemic<\/span><\/b><span data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">All ED visits for adults living in Ontario, Canada were identified from 2014 to 2023. The researchers assessed trends in ED visits and compared a more recent time period (April 1, 2022 to March 31, 2023) to a pre-pandemic baseline period (April 1, 2014 to March 31, 2020). For this comparison, only the first LWBS ED visit was assessed, as repeated visits may have signaled differences in an individual\u2019s health risk or patterns in health care use.<\/span><span data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Key findings include:<\/span><span data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">Rates of <\/span><b><span data-contrast=\"none\">monthly total<\/span><\/b><span data-contrast=\"none\"> and <\/span><b><span data-contrast=\"none\">LWBS ED visits<\/span><\/b><span data-contrast=\"none\"> for adults were higher and remained elevated longer in Ontario EDs, exceeding the single-month pre-pandemic peak LWBS ED visit rate of 4% during 15 out of 36 months between 2020 and 2023 (42% of the time) and 9 out of 12 months (75% of the time) during the most recent period of 2022 and 2023.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">Patients with a LWBS ED visits during 2022-2023 had a <\/span><b><span data-contrast=\"none\">14% higher risk of death or hospitalization within 7 days<\/span><\/b><span data-contrast=\"none\">, despite similar post-ED follow-up (i.e. a visit to a family doctor or other healthcare visit).<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"none\">Patients in the 2022-2023 LWBS group had a <\/span><b><span data-contrast=\"none\">median age of 41 years<\/span><\/b><span data-contrast=\"none\">, and 74% had no history of hospitalization in the prior five years.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"none\">A follow-up analysis that looked at <\/span><b><span data-contrast=\"none\">all-cause mortality<\/span><\/b><span data-contrast=\"none\"> found a 46% higher risk of death at 7 days and 24% higher risk at 30 days.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"none\">There was <\/span><b><span data-contrast=\"none\">no evidence<\/span><\/b><span data-contrast=\"none\"> to show that patients were seeking emergency care for minor issues or as an alternative to outpatient care.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"none\">\u201cWhat\u2019s striking about these findings is that people leaving the ED are younger and have no history of hospitalization,\u201d says Dr. McNaughton. \u201cAnother red flag is that many made contact with primary care and still had a higher risk of dying.\u201d<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">The authors caution that these events should not be considered benign, especially in the context of rising rates of ED visits, on-going closures of EDs (particularly in rural areas), inadequate long-term care beds, nurses and physician shortages, and worsening access to primary care.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559685&quot;:0,&quot;335559737&quot;:0,&quot;335559738&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:279}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">\u201c<\/span><span data-contrast=\"auto\">Taken together, our findings suggest that people seeking emergency care may now be at greater risk for poor outcomes than in the past. Our universal health care system urgently needs significant investment of resources to support both emergency and primary care, in order to meet the health care needs of our growing, aging, and increasingly medically complex population<\/span><span data-contrast=\"none\">.\u201d<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559685&quot;:0,&quot;335559737&quot;:0,&quot;335559738&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:279}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">The article \u201c<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1002\/emp2.13299\" target=\"_blank\" rel=\"noopener\">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<\/a>\u201d was published in the <\/span><i><span data-contrast=\"none\">Journal of the American College of Emergency Physicians<\/span><\/i><span data-contrast=\"none\">.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:279}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">ICES<\/span><\/b><span data-contrast=\"none\"> is an independent, not-for-profit research and analytics institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. ICES leads cutting-edge studies and analyses evaluating healthcare policy, delivery, and population outcomes. Our knowledge is highly regarded in Canada and abroad and is widely used by government, hospitals, planners, and practitioners to make decisions about healthcare delivery and to develop policy. For the latest ICES news, follow us on X, formerly Twitter: @ICESOntario<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">FOR FURTHER INFORMATION PLEASE CONTACT:<\/span><\/b><span data-contrast=\"none\">\u202f<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Misty Pratt\u202f<\/span><br \/>\n<span data-contrast=\"none\">Senior Communications Associate, ICES\u202f<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\"><br \/>\n<\/span><a href=\"mailto:Misty.Pratt@ices.on.ca\"><span data-contrast=\"none\">Misty.Pratt@ices.on.ca<\/span><\/a><span data-contrast=\"none\"> 343-961-6982<\/span><span data-ccp-props=\"{&quot;335559685&quot;:0}\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Toronto, ON, December 18, 2024 \u2013 Since 2020, more Ontario adults are leaving the emergency department without being seen and they face a 14% higher risk of death or hospitalization within seven days, according to a new study from ICES. The researchers also found that the increased risk of death or hospitalization persisted through to [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,62],"class_list":["post-20845","news_release","type-news_release","status-publish","hentry","topic-acute-and-emergency-services","topic-health-services-research"],"acf":{"infographic":[20848],"journal_article":[20834],"research_report":"","atlas":"","research_program":[6742],"site":[6733],"ices_scientist":[19849,1385,1383,1118,1150,1298],"announce_or_event":"","video":"","iitn_type":"Article","iitn_title":"","iitn_short_title":"","iitn_source_link_url":"","iitn_source_link_text":"","sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Patients who leave the emergency department without 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