Characteristics and outcomes of patients who "did not wait" after attending Perth public hospital emergency departments, 2000-2003

J. Hall, George Jelinek

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    19 Citations (Scopus)

    Abstract

    Objective: To determine characteristics and outcomes of patients who did not wait to see a doctor in emergency departments (EDs).Design and setting: Population-based outcome study using probabilistically linked ED and Western Australian death records, with ED records from all seven Perth public hospitals that have EDs from 1 July 2000 to 30 June 2003.Main outcome measures: Rates of "did not wait" (DNW) presentations, overall and for individual hospitals; characteristics of DNW patients; mortality rates among DNW patients at 2, 7 and 30 days.Results: DNW rates varied from 2.6% to 6.3% (average, 4.1%) and were generally lower in tertiary teaching hospitals. DNW patients had conditions of lower urgency, predominantly Australasian Triage Scale category 4 (67.1%) and 5 (23.4%). The DNW rates in these categories were 5.8% and 10.6%, respectively (P < 0.001). Patients referred by health care providers had lower DNW rates (0.5%; P < 0.001). DNW patients were more frequently male (4.4% v 3.8%; P < 0.001), and young to middle-aged adults (15-44 years; 5.8%; P < 0.001). Patients with a higher than average DNW rate were more likely to arrive by private transport (5.0%; P < 0.001) or with police (5.8%; P < 0.001), re-present for review (8.6%; P < 0.001) or have social or behavioural problems (7.7%; P < 0.001). Most patients (91.9%) did not wait on only one occasion. The 30-day mortality rate among DNW patients was significantly lower than for patients seen by a doctor and discharged (0.14 v 0.20%; P = 0.026), and for all patients seen, in the ED (1.28%; P < 0.001).Conclusions: Patients who did not wait for medical assessment in Perth EDs had conditions of lower acuity and had lower mortality rates than those who waited for assessment.
    Original languageEnglish
    Pages (from-to)626-629
    JournalMedical Journal of Australia
    Volume187
    Issue number11
    Publication statusPublished - 2007

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