NEW YORK (Reuters Health) - Because of long waits, some children who are brought to an emergency room never get treated before they and their caretakers have to leave.

A new study reports that, in the US, about 2 percent of children who visit an emergency department leave before they are seen -- about the same rate as among adults.

"Emergency department crowding has become a national crisis," Dr. Florence T. Bourgeois, of Harvard Medical School, Boston, and colleagues point out in the Annals of Emergency Medicine. "One of the most significant consequences of emergency department crowding occurs when long waits and patient dissatisfaction lead to patients leaving before they have seen a clinician."

Between 2000 and 2005, the "leave-without-being-seen" rates among children appeared to increase; however, this increase was not significant from a statistical standpoint, Bourgeois' team reports.

Factors associated with leaving without being seen for both children and adults included urban location, self-pay insurance status, and less acute triage level.

Among adults, race, ethnicity and arrival time were associated with leaving without being seen. The lowest rate was seen among non-Hispanic white patients.

For children, race or ethnicity was not a factor, but those who arrived between 4 p.m. and midnight were more likely to leave without being seen.

SOURCE: Annals of Emergency Medicine, December 2008.

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