Number of patients leaving Quebec emergency departments before being seen on the rise

The number of patients leaving emergency departments before being taken care of is on the rise in Quebec, according to the results of a study by the Montreal Economic Institute (MEI) published Thursday.

In 2023-2024, over a period of approximately 11 months, 3.2 million patients visited Quebec's emergency departments, and 11.5 per cent of them, or 376,460 people, left before receiving medical attention.

By comparison, in 2018-2019, it was just over 10 per cent, or 378,348 patients out of a total of 3.7 million visits.

"One person in two waits more than five hours in the emergency department in Quebec. It's not surprising that many will leave," said study author Emmanuelle B. Faubert.

Patients referred to another health-care professional who can meet their needs are not counted in these data, as they are considered to have been taken into care.

"This is still an increase because the study period in 2023-2024 is 11 months. So we see that in 11 months (...) we have essentially the same number of patients who left the ER before treatment compared to (a period) of one year five years ago," said Faubert. "That's still a problem, considering the increased budgets we're putting into health care and all the reforms we're making every year."

She is particularly concerned about the 103,715 patients in categories P1, P2 and P3, which correspond to the most urgent cases. According to data she obtained from the Ministère de la Santé et des Services sociaux, 25.3 per cent of Priority 3 patients left the emergency department before receiving medical care, 2.2 per cent of P2 patients and 0.03 per cent of P1 patients.

The proportion of P1 to P3 patients who left the emergency department because they had not consulted a professional available to treat them rose from 21.9 per cent in 2018-2019 to 27.5 per cent in 2023-2024.

"This is a big problem because it shows that our health-care system is incapable of taking care of Quebecers. And it's dangerous when you consider that the population is aging and needs are increasing," said Faubert.

For less urgent cases (P4 and P5), over 70 per cent of patients decided to leave the ER without being treated.

"People who aren't (urgent cases) don't go (to the ER) for a walk in the park. They go there because they need help, they need care, whether it's urgent or not. They go there because they can't find a better option elsewhere because we have a problem of access to the front line," the economist said.

She pointed out that a patient who leaves without treatment runs the risk of worsening his or her condition and returning to the emergency department as a more complex case.

Specialized nurse practitioner (SNP) clinics can be part of the solution, according to Faubert. There are 11 in the province, and their number is expected to double by 2028, but the economist believes that more need to be deployed, more quickly.

She also described as "excellent news" the expansion of diagnostics to other health-care professionals, including pharmacists and nurses, included in the recently passed Bill 67.

"This is a step in the right direction," she says.

This report by The Canadian Press was first published in French on June 20, 2024.

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