Volume 16, Number 2 (7-2017)                   jhosp 2017, 16(2): 19-26 | Back to browse issues page


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salehi S, khatami F, anvari S, omidi N, Sedaghat Siyahkal M, effatpanah M. Discharges Against Medical Advice and Its Effective Factors among Patients Referred to Ziaeian Hospital. jhosp. 2017; 16 (2) :19-26
URL: http://jhosp.tums.ac.ir/article-1-5564-en.html

1- BSc in Healthcare Services Management, Ziaeian Hospital, International Campus, Tehran University of Medical Sciences, Tehran, Iran
2- Assistant Professor, Community Medicine Department, Tehran University of Medical Sciences, Tehran, Iran
3- General Practitioner, Ziaeian Hospital, International Campus, Tehran University of Medical Sciences, Tehran, Iran
4- Assistant Professor, Cardiac Primary Prevention Research Center, Tehran Heart Enter, , Tehran University of Medical Sciences, Tehran, Iran
5- Associate Professor, Community Medicine Department, Tehran University of Medical Sciences, Tehran, Iran
6- Assistant Professor, Ziaeian Hospital, International Campus, Tehran University of Medical Sciences, Tehran, Iran (*Corresponding author)
Abstract:   (641 Views)

Background: Decision to stop or continue the treatment after awareness about complications and risks is patients' rights. On the other hand, patient`s discharge against medical advice could threaten patients' health. This study aimed to determine the causes of patient`s discharge against medical advice to prevent negative effects on patients and health costs.

Materials and Methods: In this study, 342 patients who left hospitals regarding discharge against medical advice were enrolled. Up to 48 hours of leaving hospital, the patients were received telephone contact, and if consented, were asked about the potential causes and whether or not the explanation of nurses or physician about the risks and side effects of discharge against medical advice. Furthermore, causes of discharge against medical advice were categorized as patient, hospital condition and combined causes.

Results: Study findings revealed that 48.5% of patients with personal reasons, 26% because of dissatisfaction with the service and 25.5% due to a combination of causes left the hospital. Most of the patients were in emergency department (p<0.001). There was relationship between type of disease (p= 0.037) and referred shift of patients (p=0.002) with type of discharge.

Conclusion: Given to the study results, it seems that planning for providing and maintaining human resources, training staff especially new entrance, monitoring medical team performance and organizing the triage system are essential in patient`s discharge against medical advice.

Full-Text [PDF 672 kb]   (108 Downloads)    
Type of Study: Original Article | Subject: سیاست گذاری ، برنامه ریزی و رهبری و مدیریت در بیمارستان
Received: 2015/09/22 | Accepted: 2016/06/1 | Published: 2017/07/8

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