Hospital self-discharge among adults with sickle-cell disease (SCD): associations with trust and interpersonal experiences with care.

BACKGROUND

Patient self-discharge from hospitals has been associated with a number of negative clinical outcomes. Research suggests that low patient trust and poor quality interpersonal experiences with care may be associated with hospital self-discharge. Although adults with sickle-cell disease (SCD) often report poorer quality healthcare experiences, research examining hospital self-discharge and its associations with both patient trust and quality of healthcare experiences is lacking for this patient population.

OBJECTIVE

To examine the association of interpersonal experiences with care and trust in the medical profession with hospital self-discharge history among patients with SCD.

DESIGN

Cross-sectional study.

SETTING

A large, urban academic medical center.

PATIENTS

Adults (age 18+ years) with SCD seeking outpatient or inpatient care.

MEASUREMENTS

We compared patient characteristics, patient perceptions of the quality of interpersonal experiences with care, and levels of trust between patients with and without a history of hospital self-discharge.

RESULTS

Adjusted analyses indicated that having a history of hospital self-discharge was associated with more negative interpersonal experiences and lower levels of trust.

CONCLUSIONS

Hospital self-discharge may be an important indicator of the quality of care received by adults with SCD. Further research is needed to better understand this phenomenon so that effective interventions can be designed to prevent its occurrence.