Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
Prevention of Psychosocial Injuries Research Centre, Ilam University of Medical Sciences, Ilam, Iran.
Int J Health Policy Manag. 2014 Oct 30;4(3):137-41. doi: 10.15171/ijhpm.2014.110. eCollection 2015 Mar.
Patients' escape from hospital imposes a significant cost to patients as well as the health system. Besides, for these patients, exposure to adverse events (such as suicide, self-harm, violence and harm to hospital reputation) are more likely to occur compared to others. The present study aimed to determine the characteristics of the absconding patients in a general hospital through a case-control design in Shiraz, Iran.
This case-control study was conducted on 413 absconded patients as case and 413 patients as control in a large general hospital in Shiraz, southern Iran. In this study, data on the case and control patients was collected from the medical records using a standard checklist in the period of 2011-3. Then, the data were analyzed using descriptive and analytical statistics, through SPSS 16.
The finding showed that 413 patients absconded (0.50%) and mean of age in case group was 40.98 ± 16.31 years. In univariate analysis, variables of gender [Odds Ratio (OR)= 2], ward (OR= 1.22), insurance status (OR= 0.41), job status (OR= 0.34) and residence expenditure were significant. However, in multivariate analysis significant variables were age (ORadj= 0.13), gender (ORadj= 2.15), self-employment/unemployed (ORadj= 0.47), emergency/admission (ORadj= 2.14), internal/admission (ORadj= 3.16), insurance status (ORadj= 4.49) and residence expenditure (ORadj= 1.15).
Characteristics such as middle age, male gender, no insurance coverage, inability to afford hospital expenditures and admission in emergency department make patients more likely abscond from the hospital. Therefore, it may be necessary to focus efforts on high-risk groups and increase insurance coverage in the country to prevent absconding from hospital.
患者从医院逃离不仅会给患者自身，也会给医疗系统带来巨大的经济负担。此外，与其他患者相比，这些逃院患者更有可能遭遇不良事件（如自杀、自残、暴力和损害医院声誉等）。本研究旨在通过伊朗设拉子一家大型综合医院的病例对照设计，确定一般医院逃院患者的特征。
本病例对照研究纳入了伊朗南部设拉子一家大型综合医院的 413 名逃院患者作为病例，以及 413 名患者作为对照。在这项研究中，通过使用标准清单从病历中收集病例和对照患者的数据，研究时间为 2011 年 3 月至 2011 年 3 月。然后，使用 SPSS 16 进行描述性和分析性统计分析。
研究发现，共有 413 名患者（0.50%）逃院，病例组的平均年龄为 40.98±16.31 岁。在单变量分析中，性别（OR=2）、病房（OR=1.22）、保险状况（OR=0.41）、职业状况（OR=0.34）和居住支出等变量有统计学意义。然而，在多变量分析中，有统计学意义的变量为年龄（ORadj=0.13）、性别（ORadj=2.15）、个体经营/失业（ORadj=0.47）、急诊/入院（ORadj=2.14）、内科/入院（ORadj=3.16）、保险状况（ORadj=4.49）和居住支出（ORadj=1.15）。
年龄在中年、男性、无保险、无法负担住院费用和因急诊入院等特征使患者更有可能从医院逃院。因此，可能有必要将重点放在高危人群上，并增加国家的保险覆盖范围，以防止逃院。
