The number of patients walking out of emergency departments (ED) without being formally discharged has reached record levels.
Some 13,500 people abandoned their visit to the ED in January of 2018 and December of 2017. One in 16 patients who arrived seeking emergency medical care left without it, frustrated by lengthy queues, and either went elsewhere for treatment or went home.
The figures for those two months include 859 children, whose parents took them home without medical treatment. The HSE said there were a variety of reasons why patients might leave an emergency department, not only wait times. However, the numbers leaving without care have climbed just as waiting lists in hospitals have reached their highest levels.
In January, 6,499 people were classified as ‘did not waits’, compared to 4,777 people in the same month in 2017. The figure was worse in December, when 7,055 people — or 6.3% of all patients presenting — went home without formal discharge from hospital. There has been a steady rise in the percentage of patients not waiting for emergency treatment, from 4.8% in January, 2017, to 6% and above in the two most recent months for which figures are available.
The number of patients abandoning their ED visit was highest in three Dublin hospitals: the Mater, St James, and Tallaght. At the Mater, the number of ‘did not waits’ in January was 1,292, up to 19.8% of the national total. So, one in five people who presented at the Mater Hospital did not stay for their treatment.
Very high rates for ‘did not waits’ were also recorded at Tallaght (17.8%) and St James’ Hospital (16.6%) in January. Outside of Dublin, the highest number of patients who left early was recorded at University Hospital Limerick (341) and Our Lady of Lourdes, in Drogheda (307). However, the ‘did not wait’ percentage at both hospitals was 5.7%, just below the national average.
In Cork, 206 people left the A&E of the Mercy University Hospital in January, without being medically cleared. That was 7% of the number of patients seeking treatment. Altogether, during the year, 72,000 patients presented at an emergency department and were then classified as ‘did not wait’, the figures, released under FOI, show.
Of that, 3,420 had been seeking treatment at one of the three children’s hospitals in Dublin: Crumlin, Temple Street, and Tallaght.
The HSE said: “Due to the unplanned nature of patient attendance, the department must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention.
“Triage is the process of determining the priority of patients’ treatments, based on the severity of their condition. Triage may result in determining the order and priority of emergency treatment, the order and priority of emergency transport, or the transport destination for the patient.
“Patients that choose to leave before receiving treatment, in an emergency department, do so for a variety of reasons, including receiving treatment elsewhere, their issue being resolved, wait times, and an improvement in condition.”
The HSE said high figures in central Dublin were partly due to higher rates of deprivation and addiction and “comorbidity challenges”.
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