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.
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