Document Type : Original Article

Authors

• yalda ravanshad ¹
• Mohadese Golsorkhi ²
• elham Bakhtiari ³
• aghil lollah keykhosravi ⁴
• anoush azarfar
• malihe shoja ⁵
• mohamad behazin ⁶
• sahar ravanshad ⁷
• alireza ghodsi ⁸

¹ Assistant professor, Department of Community Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran.

² Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

³ 2. Assistant professor, Clinical Research Development Unit, Mashhad University of Medical Sciences, Mashhad, Iran

⁴ 4. Faculty of Medicine, sabzevar University of Medical Sciences,

⁵ 5. Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

⁶ Mashhad University of Medical Sciences, Mashhad, Iran

⁷ 6. Department of internal medicine, Mashhad University of Medical Sciences, Mashhad, Iran

⁸ departmant of pediatric

Abstract

Introduction: The patient’s self-discharge from the hospital is a process in which the patient leaves the hospital voluntarily without completing the course of treatment, despite medical advice, and can indicate patient dissatisfaction and a significant challenge for health system managers. This study was conducted to investigate the causes and consequences of a patient's self-discharge from Dr. Sheikh Hospital as a referral center in the northeast of Iran.
Material and Method: All patients who were discharged with the personal consent from the hospital with personal consent between October 2014 and March 2015 were included in the study. A checklist was used to collect data. The patients' outcome was completed by telephone a week later. Finally, SPSS statistical software was used to evaluate the results.
Results: Totally, 51 patients were included in this study. The leading causes of discharge with personal consent were including dissatisfaction with the physician and medical staff in 23 patients (45.1%), home care preference in 12 patients (23.5%), distance from the hospital in 5 patients (9.8%), teaching at the hospital in 3 patients (،5.9), the high cost of treatment in 3 patients (9 5.9), the overcrowding of the hospital in 3 patients (9 5.9) and the lack of specialist or diagnostic and therapeutic devices in 2 patients (3.9%). Also, in the study of patients' outcome, 21 patients (41.1%) referred to the doctor again, 18 patients (35.3%) continued treatment at home, 9 patients (17.7%) were readmitted and 2 patients (3.9%) died.
Conclusion: The most common cause of discharge with personal consent was dissatisfaction from the treatment team. Given that 3.9% of patients have died and a large number of patients have been re-referred to the doctor and be readmitted, it seems that justifying patients to refrain from self-discharge is in the patient's best interest.

Keywords

• Informed Consent
• Patient Discharge
• Hospital, Doctor

Main Subjects

• Epidemiology and Statistics