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# Behavioural health ED patients leaving unseen return, are admitted and die more often
- URL: https://www.coios.me/behavioural-health-ed-patients-leaving-unseen-return-are/
- Published: 2026-10-23T13:02:30.000Z
- Updated: 2026-10-23T17:03:30.000Z
- Description: Among 1,305,812 US emergency department behavioural health episodes, a 7-day return visit followed 24.5% of those leaving without being seen, against 13.2% after completed care.
- Author: Daniel Ryan
- Tags: Data, models and systems, Health systems and access, United States, #preprint, #new, #item, #source-2026-10, #score-62

This retrospective episode-level cohort study compared return visits, admission and death after leaving without being seen (LWBS) versus completed care. It used a multisystem deidentified US electronic health record database of 1,305,812 emergency department behavioural health episodes. Episodes came from 525,490 patients, 12,248 of them LWBS, each followed for 30 days. Return visit within 7 days followed 24.5% of LWBS episodes against 13.2% after completed care (RR 1.86). Admission on days 1-7 followed 17.1% against 3.9% (RR 4.41), and 30-day death 0.69% against 0.32% (RR 2.15). Mortality was assessed only in 2017-2023 episodes; comparisons are unadjusted and patients could contribute episodes to both groups.

*Why it is interesting: Quantifies outcomes for behavioural health patients who leave before assessment, a group usually lost from data. The admission and mortality gaps are large.*

Source

[medRxiv, 20 October 2026](https://doi.org/10.64898/2026.10.14.26365554?ref=coios.me)

Paper

Return Visits, Admission, and Mortality After Leaving Without Being Seen Among Emergency Department Patients With Behavioral Health Presentations

Authors

Ashoo S, Peacock WF, Colovos C, Durieux J

DOI

10.64898/2026.10.14.26365554

Type

Preprint

Design

Retrospective episode-level cohort in a multisystem deidentified US EHR database; 1,305,812 ED episodes (12,248 LWBS) from 525,490 patients, index visits 2001-2025, mortality assessed 2017-2023

Verdict

New finding

Driver

[Health systems and access](https://www.coios.me/d-health-systems/)