The Longer Patients Wait in the ED, the More of Them Leave Against Medical Advice

There’s a strange dichotomy afoot in California emergency rooms: Patients are heading to the emergency room in greater numbers than in years past—but even more of them are leaving against medical advice out of frustration over waiting so long to see a provider, according to data from the Office of Statewide Health Planning and Development and published recently in California Healthline. Approximately 352,000 ED visits in 2017 ended with patients leaving after seeing a doctor but before their medical care was complete, an increase of 57% over the 128,000 similar incidents that took place in 2012, the last time such data were collected. Another 322,000 left before they even saw a provider. Multiple hospital administrators blamed overcrowding for the phenomenon, noting that the number of California ED visits jumped nearly 20% between 2012 and 2017. Median wait times in California EDs also grew during that period, from 321 minutes in 2012 to 336 minutes—that’s over 5½ hours—in 2017. The report did not detail where patients went after leaving the ED, so there’s no way of knowing if they had the wherewithal to visit an urgent care center.