To examine temporal trends and hospital factors influencing patients leaving emergency departments (ED) without being seen (LWBS) in California from 2015 to 2024.
Key Findings:
Total LWBS rates decreased from 2.8% in 2015 to 2.2% in 2020, then increased to 3.4% in 2022 before decreasing to 2.6% in 2024.
LWBS rates were significantly higher at urban (2.6%) vs rural (2.1%), government-owned (3.9%) vs for-profit (2.4%), and safety net (3.3%) vs non-safety net (2.3%) hospitals.
Worst-performing hospitals had LWBS rates exceeding 3 times the median, reaching 9.9% in 2022.
Interpretation:
The study indicates a concerning reversal in LWBS trends, highlighting persistent disparities in ED access, particularly for underserved populations.
Limitations:
Potential errors in hospital data reporting.
Lack of visit-level data to analyze patient-specific factors associated with LWBS.
Conclusion:
Disparities in LWBS may continue to affect equitable emergency care access unless systemic issues are addressed.
