Carmel A, Amital H, Shemer Y, Sahar A
Emergency Dept., Gertner Institute for Medical Service Research, Chaim Sheba Medical Center, Tel Hashomer.
Harefuah. 1998 Mar 15;134(6):445-9, 503.
The object of this study was to characterize those who leave the emergency department against medical advice and to examine the short-term consequences. The study was conducted retrospectively during 1992 and prospectively during May-August 1993 by telephone interviews. About 0.5% of all the patients who applied to the emergency department left against medical advice. Their main characteristics was that they were mostly young, single men. A wide range of complaints had brought them to the emergency department, very similar to that of the control group, but with a higher tendency to abuse drugs and alcohol. Most of those who left against medical advice had less severe disease than the controls. However 10% of them had to be hospitalized within the subsequent 2 weeks, in comparison with 4% of the controls. This study suggests that improving the efficiency of the emergency department will decrease the number leaving against advice.
本研究的目的是对那些违背医嘱擅自离开急诊科的患者进行特征描述，并考察其短期后果。该研究于1992年进行回顾性研究，并于1993年5月至8月通过电话访谈进行前瞻性研究。所有前往急诊科就诊的患者中，约0.5%的人违背医嘱擅自离开。他们的主要特征是大多为年轻单身男性。各种各样的症状促使他们前来急诊科，这与对照组非常相似，但他们滥用药物和酒精的倾向更高。大多数违背医嘱擅自离开的患者病情比对照组轻。然而，在随后的2周内，他们中有10%不得不住院治疗，而对照组为4%。本研究表明，提高急诊科的效率将减少违背医嘱擅自离开的人数。
