Increased Odds of Leaving ED Before Medically Advised Tied to COVID-19 Pandemic

MONDAY, Feb. 24, 2025 (HealthDay News) — In the United States, the COVID-19 pandemic was associated with increased odds of leaving the emergency department before medically advised (BMA), according to a study published in the April issue of the American Journal of Emergency Medicine.

Yahya Alnashri, M.D., M.P.H., from Prince Sattam bin Abdulaziz University in Al-Kharj, Saudi Arabia, and colleagues conducted a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2016 to 2021 to examine factors associated with leaving BMA from emergency departments.

Overall, 5.9 million (0.8 percent) of 721.0 million emergency department visits resulted in leaving BMA. The researchers found that the odds of leaving BMA were increased in association with public or no insurance coverage (Medicare, Medicaid/CHIP/state-based, uninsured/self-pay: adjusted odds ratios, 1.74, 1.86, and 1.51, respectively), alcohol or substance use disorders (adjusted odds ratio, 2.19), arrival by ambulance (adjusted odds ratio, 1.68), and being male (adjusted odds ratio, 1.32). Lower odds of leaving BMA were seen in association with hospital admissions and trauma or overdose-related visits (adjusted odds ratios, 0.11 and 0.54, respectively). Significantly increased odds of leaving BMA were seen in association with the COVID-19 pandemic (adjusted odds ratio, 1.44), with an overall increase of 53.6 percent in BMA-related emergency department visits post-March 2020 versus previous years.

“These findings highlight the need for targeted interventions to improve patient-provider communication and ED triage efficiency, especially in resource-constrained facilities serving lower-income individuals,” the authors write.

Abstract/Full Text (subscription or payment may be required)