We have described the relationship of LWBS with age, triage category, day of week, and shift of day, diversion status and waiting time. We found that in this study LWBS were 13% which is comparable to other international data (1.0 – 15%) but higher than the benchmark set by USA (1.7%)

[16,17,33]. Although the sex of those who LWBS does not have significant effect in a multiple regression model, it appears that age of a patient Inhibitors,research,lifescience,medical had a profound impact (Table 3). The odds of leaving for male patient who is 20–40 years of age is 17 times more than a patient at extremes of age, regardless of severity of illness. Children were found to be at a lower risk of being left, this may show increased sensitivity and nonspecific sign and symptoms towards extremes of age that gives them priority over other age groups [15,23,34]. Proportion of LWBS are higher in females

contrary to international data may be because in our community structure Inhibitors,research,lifescience,medical females have the responsibility of Inhibitors,research,lifescience,medical taking care of all the household things as well their health is not given as much priority because of existing inequities in our communities [35,36]. It was observed that higher proportions of low acuity (98.2%) MEK162 ARRY-438162 patients with less severe illnesses like fever, upper respiratory tract infection (URTI), acute gastroenteritis were leaving. Research has shown that LWBS and acuity has a dose- response Inhibitors,research,lifescience,medical relationship; with 15.2% of non-urgent patients leaving as compared to 0.1% of critical patients [10,13,37]. The fact that most of those patients who left although had low acuity illnesses yet they required some work up or treatment e.g. abdominal pain or diarrhea with dehydration, highlights the importance of accessibility of urgent care settings or short stay units. This could be assessed by the percentage of subsequent Inhibitors,research,lifescience,medical return visit in the ED after leaving. The return visits in our study are found to be 3.6% much higher than the internationally reported numbers (1.2%) in a USA study with 1.5% requiring hospital admission subsequently

[38]. A high number of walk-in patients such as those with fever or URTI utilize the ED mostly in after hours, and usually spend a long time in waiting because of their relatively stable condition. This fact also emphasizes the need for creating structures such as fast track Clinics Drug_discovery or urgent care centers that cater the high influx of patients with seasonal illnesses who need not be referred to a tertiary care hospital for treatment and a separate patient care area for elderly patients [39-42]. From the results, it appears that patients who are asked to wait for a longer time period are also more likely to leave than those who are assigned bed within a relatively shorter time span. The odds for leaving in this study are 0.