Factors associated with walkout of patients from New South Wales hospital emergency departments, Australia

Emerg Med Australas. 2005 Oct-Dec;17(5-6):434-42. doi: 10.1111/j.1742-6723.2005.00774.x.


Objective: To explore the association between daily patient numbers, sociodemographic, clinical and system characteristics and walkout rates of patients from New South Wales (NSW) public hospital ED (without seeing a medical officer).

Methods: This was a secondary analysis of the NSW Emergency Department Data Collection, between 1 January 1999 and 31 December 2001, with a total of 4 356 323 ED attendances. Bivariate and multiple logistic regression analyses were performed to explore the relationship of walkout from ED and explanatory variables.

Results: About 5.7% of the patients attending in NSW public hospital ED left without seeing a doctor. The results from bivariate and multivariate analyses revealed that walkout rates significantly varied by sociodemographic and clinical characteristics of the patients. Patient groups that more likely to walk out were those aged 15-44 years, from a non-English-speaking background, Aboriginal, with lower socioeconomic status, with no private health insurance coverage and longer waiting times for triage. Patient volume in the ED showed a significant positive association with walkout rates.

Conclusions: After adjusting for triage category (urgency of presentation) and triage time, patients from lower socioeconomic backgrounds and those without private health insurance coverage were more likely to leave ED without treatment. These results have important implications for Health Services. Future strategies aimed at minimizing walkouts from public hospital ED should prioritize and target factors identified in the present study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Ambulances / statistics & numerical data
  • Child
  • Child, Preschool
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Health Care Surveys
  • Hospitals, Rural / statistics & numerical data
  • Hospitals, Urban / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Insurance, Health / statistics & numerical data
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Native Hawaiian or Other Pacific Islander / statistics & numerical data
  • New South Wales
  • Odds Ratio
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Sex Distribution
  • Socioeconomic Factors
  • Waiting Lists