Record number of patients leaving EDs without complete care

Amid rebounding emergency department volumes and growing wait times, patients are increasingly leaving emergency departments before completing treatment, according to Emergency Department Benchmarking Alliance data shared with Becker's.   

EDBA, a consortium of more than 1,500 EDs nationwide, released its preliminary report on 2022 performance measures in June. The annual report is based on survey responses from member organizations.

The percentage of patients who left the ED before completing treatment increased from 2.7 percent in 2019 to 4.6 percent in 2022.

"This is the highest LBTC rate that has ever been seen, and means that about 7 million patients who wanted ED care left without that service," James Augustine, MD, vice president and board member of EDBA, wrote in a June blog post for American College of Emergency Physicians. "That amounts to more than $1 billion dollars in lost ED physician revenue."

This trend comes amid a significant annual increase in ED patient processing times. The overall length of stay for ED patients was 199 minutes in 2022, up from 182 minutes in 2018, according to the report. Boarding times also increased, despite emergency department leaders' efforts to improve patient flow. Average boarding time — or the time it takes to transition a patient from the ED to beds in hospital wings, psychiatric facilities or nursing homes — jumped from 121 minutes in 2020 to 192 minutes in 2022. 

Shortening boarding hours remains a top priority for emergency department leaders. Some hospitals are taking creative approaches to improve ED flow, including eliminating waiting rooms, opening discharge lounges and using machine learning models to predict patient demand.

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