Why do more than 4,000 people a month walk out of A&E without ever being discharged?

MORE than 4,000 people a month are walking out of Irish hospital emergency departments, many of them frustrated at incredibly long waits for treatment or to get seen by a doctor.

Figures obtained under FOI show that more than 41,000 people simply abandoned their visit to casualty and left without ever being formally discharged during the first ten months of last year.

The figures include more than 2,500 children, brought home by their mothers and fathers without a final decision ever having been made on whether they needed further treatment, admission or discharge.

The figures show the problem of “did not waits” was most acute in the Mater and Tallaght Hospitals in Dublin, where hundreds of patients leave each month without formal discharge.

In the Mater Hospital, the number of patients leaving the ED was 590 in January of last year but began to rise consistently throughout the year, peaking at 766 in August.

At Tallaght Hospital, the amount of people walking out of casualty without a full assessment averaged out at around 370 per month in 2015.

The HSE has said that nobody should be leaving an emergency department once they have sought help, without either being admitted or formally discharged.

The HSE explained that the figures were recorded by all emergency departments on the basis of what they classified as “did not wait” patients.

“This refers to service users who register at an ED and who choose to leave without actively discharging themselves,” they said.

“The category covers a number of scenarios. A service user may choose to leave either before or after triage. They may choose to leave without waiting to see [senior medical personnel] … or they may choose to leave after seeing one of these but for example, without waiting for tests, tests results etc.”

The HSE did say that once a patient registers – this was taken to mean that they were “requesting help”.

“The advice in such circumstances, irrespective of whether a health professional has seen and advised that individual, would be to remain until admitted or discharged.”

They said all patients were triaged for treatment and care and that priority was always given to those requiring immediate and urgent care.

The figures for patients leaving EDs also at times parallel the numbers of patients on trolleys, another obvious sign of chronic overcrowding.

In January 2015, a total of 3,677 patients abandoned A&Es, a figure that rose in the following months reaching 4,588 in March.

The annual INMO trolley report also shows that same clear spike in trolley numbers with figures rising markedly from January to March.

No hospital was immune to the problem with the highest numbers recorded in the main urban centres where ED Departments are of course busiest.

Apart from the Mater and Tallaght in Dublin, the number of walk-outs at Galway University Hospitals was 3,559 while in University Hospital Limerick, it was 3,100.

Figures of above 2,000 were recorded at Connolly Hospital in Blanchardstown (2,424) and Saint Vincent’s University Hospital (2,063) on Dublin’s Southside.

High figures were also reported at Our Lady of Lourdes Hospital in Drogheda (1,978), Naas General Hospital (1,684), and Mercy University Hospital Cork (1,859).

More than 2,500 young patients were also listed as “did not wait” at the three main children’s hospitals in Dublin: Temple Street, Crumlin and Tallaght.

Fianna Fáil TD Billy Kelleher said: “It is an indication that people just don’t have confidence in being treated in a timely fashion at our emergency departments.

“A lot of this is probably coming out of frustration, or an exorbitant wait in time, and patients just start to leave themselves. A lot of people are obviously just seeing this overcrowding, and it shatters their confidence in the services.

“These are people that are going to hospital, who obviously feel they are sick enough to merit that, and then end up just leaving, which is simply unacceptable.”

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