Estimating Direct Revenue Margin Impact from ED Patients Who Leave Without Being Seen

BRG professionals recently conducted an analysis on the financial impact of emergency department (ED) patients who leave without being seen (LWBS). LWBS rates often serve as the canary in the coal mine for the ED, as they are often influenced by high wait times, ED crowding/overcrowding, and patient volumes. We frequently identify arrival-to-provider processes, lab and imaging utilization, efficiency, availability, and staff-to-patient demand as other factors impacting LWBS rates. Patients who have LWBS are both a quality risk and a financial liability to the organization; patients who leave can have adverse outcomes secondary to delayed treatment or no treatment, and the LWBS also represents a lost revenue opportunity. LWBS also impacts the patient experience and community perception of the ED’s ability to provide quality and timely emergency care.

Organizations should evaluate their EDs’ specific LWBS causative factors and institute evidence-based strategies to reduce LWBS.