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Patients who left without being seen (LWBS) by a physician from a pediatric emergency department (ED)/urgent care (UC) center have become a serious challenge facing emergency medicine practitioners and hospitals. Not only does this serve as an indicator of patient dissatisfaction and delay of treatment, but it also results in a loss of billable charges for the hospital and physician medical group. This study was intended to estimate the amount of lost billable charges accumulated over one year as a result of 1,193 pediatric patients who LWBS from a large academic tertiary care urban children’s hospital. Parents or caretakers of the patients listed as LWBS were contacted by an investigator from the study team, and a telephone interview consisting of 19 questions was conducted, lasting 10 to 15 minutes. Three hundred and twenty three subjects participated in the study, which accounted for 27% of the patients who LWBS after registering. Using the information provided by the respondents, projected lost charges were extrapolated for each patient that LWBS. These included hospital charges and physician charges for each patient visit. The lost hospital charges for the respondents were $232,085, and the lost physician charges were $69,949. Extrapolating these results for all 1,193 patients who LWBS during the one year study period, we estimated lost charges of approximately $1,115,455 (hospital charges $857,170, physician charges $258,284). This study showed that a significant revenue stream is lost when caregivers/parents of patients who register to be seen choose to LWBS.

Patients Who Left Without Being Seen From a Pediatric Emergency Department: A Financial Perspective