Refusal of emergency medical care: An analysis of patients who left without being seen, eloped, and left against medical advice

Catherine A. Marco, Morgan Bryant, Brock Landrum, Brenden Drerup, Mitchell Weeman

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Objective: Emergency department (ED) patients may elect to refuse any aspect of medical care. They may leave prior to physician evaluation, elope during treatment, or leave against medical advice during treatment. This study was undertaken to identify patient perspectives and reasons for refusal of care. Methods: This prospective study was conducted at an urban Level 1 Trauma Center. This study examined ED patients who left without being seen (LWBS), eloped during treatment, or left against medical advice during September to December 2018. This project included both chart review and a prospective patient survey. Results: Among 298 participants, the majority were female (54%). Most participants were White (61%) or African American (36%). Thirty-eight percent of participants left against medical advice, 23% eloped, and 39% left without being seen by a provider. When compared to the general ED population, patients who refused care were significantly younger (p < 0.001). When comparing by groups, patients who left AMA were significantly older than those who eloped or left without being seen (p < 0.001). Among 68 patients interviewed by telephone, the most common stated reasons for refusal of care included wait time (23%), unmet expectations (23%), and negative interactions with ED staff (15%). Conclusion: ED patients who refused care were significantly younger than the general ED population. Common reasons cited by patients for refusal of care included wait time, unmet expectations, and negative interactions with ED staff.

Original languageEnglish (US)
Pages (from-to)115-119
Number of pages5
JournalAmerican Journal of Emergency Medicine
Volume40
DOIs
StatePublished - Feb 2021

All Science Journal Classification (ASJC) codes

  • Emergency Medicine

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