Sheikhmoonesi Fatemeh, Khademloo Mohammad, Pazhuheshgar Samaneh
Psychiatry and Behavioral Sciences research center, Mazandaran university of Medical Sciences.
Glob J Health Sci. 2014 Mar 30;6(3):213-8. doi: 10.5539/gjhs.v6n3p213.
Self- discharged patients are at high risk for readmission and ultimately higher cost for care.We intended to find the proportion of patients who leave hospital against medical advice and explore some of their characteristics.
This prospective study of discharge against medical advice was conducted in psychiatric wards of Zare hospital in Iran, 2011. A psychologist recorded some information on a checklist based on the documented information about the patient who wanted to leave against medical advice. The psychologist interviewed these patients and recorded the reasons for discharge against medical advice. Descriptive statistics were calculated for the variables.
The rate of premature discharge was 34.4%. Compared to patients with regular discharges, patients with premature discharge were significantly more likely to be male, self-employed, to have co morbid substance abuse and first admission and positive family history of psychiatric disorder. Disappearance of symptoms was the most frequent reason for premature discharge.
The 34.4% rate of premature discharge observed in our study is higher than rate reported in other studies. One possible explanation is our teaching hospital serves a low-income urban area and most patients had low socioeconomic status. Further studies are needed to compare teaching and non-teaching hospital about the rate of premature discharge and the reasons of patients who want to leave against medical advice.
自动出院的患者再次入院风险高，最终护理成本也更高。我们旨在找出违反医嘱出院的患者比例，并探究他们的一些特征。
2011年，在伊朗扎雷医院的精神科病房对违反医嘱出院情况进行了这项前瞻性研究。一名心理学家根据记录的关于想要违反医嘱出院患者的信息，在一份清单上记录了一些信息。该心理学家对这些患者进行了访谈，并记录了违反医嘱出院的原因。对变量进行了描述性统计。
提前出院率为34.4%。与正常出院的患者相比，提前出院的患者更有可能是男性、个体经营者，有合并物质滥用情况、首次入院且有精神疾病家族史。症状消失是提前出院最常见的原因。
我们研究中观察到的34.4%的提前出院率高于其他研究报告的比率。一种可能的解释是我们的教学医院服务于低收入城市地区，大多数患者社会经济地位较低。需要进一步研究来比较教学医院和非教学医院的提前出院率以及违反医嘱出院患者的原因。
