Volume 33, Issue 2 (6-2024)
JGUMS 2024, 33(2): 188-201 |
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Research code: 432
Ethics code: IR.SEMUMS.REC.1400.173
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Yarahmadi M, Ayati M, Ghorbanian M T. Investigating the Reasons of Discharge With the Personal Consent of Patients Admitted to the Emergency Ward of Kowsar Hospital in Semnan City, Iran. JGUMS 2024; 33 (2) :188-201
URL: http://journal.gums.ac.ir/article-1-2627-en.html
URL: http://journal.gums.ac.ir/article-1-2627-en.html
1- Department of Emergency Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
2- Department of Pediatrics, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
2- Department of Pediatrics, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
Abstract: (1288 Views)
Background Discharge against medical advice indicates the dissatisfaction of patients with the care services of the health system. Additionally, it threatens patient's life and causes negative financial outcomes for hospitals.
Objective This study identifies the causes of self-discharge decisions from the emergency department at Kowsar Hospital, Semnan City, Iran.
Methods This was a descriptive-analytical study conducted between August 2021 to March 2022. The data were collected by a researcher-made questionnaire containing demographic characteristics and reasons for self-discharge, including the following three main concepts: Personal, staff-related factors, and environmental factors with sub-concepts. Meanwhile, the data were analyzed using the SPSS software, version 22.
Results A total of 140 patients with a mean age of 33.52±16.17 years were included, of which 58.6% were men and 41.4% were women. Moreover, 63.6% of patients were married, 42.1% had a diploma education, and 11.4% had a history of taking neuropsychiatric drugs. Also, 42.9% of patients were covered by social security insurance. The highest rate of self-discharge was in the evening (42.1%) and night (37.9%) shifts. The most important reasons for self-discharge decision were problems related to insurance (30%), COVID-19 infection (26.4%), poor communication (17.1%), dissatisfaction with care (15.7 %), disrespectful behavior of staff (12.9%), and inappropriate emergency ward facilities (12.1%).
Conclusion Make appropriate decisions to improve the quality of medical services and increase cooperation in health insurance, separating the departments of infectious diseases away from other departments, holding briefing sessions for physicians and medical staff, increasing awareness of patients about possible complications of self-discharge, and improving the amenities of emergency ward can reduce the rate of self-discharge decision.
Objective This study identifies the causes of self-discharge decisions from the emergency department at Kowsar Hospital, Semnan City, Iran.
Methods This was a descriptive-analytical study conducted between August 2021 to March 2022. The data were collected by a researcher-made questionnaire containing demographic characteristics and reasons for self-discharge, including the following three main concepts: Personal, staff-related factors, and environmental factors with sub-concepts. Meanwhile, the data were analyzed using the SPSS software, version 22.
Results A total of 140 patients with a mean age of 33.52±16.17 years were included, of which 58.6% were men and 41.4% were women. Moreover, 63.6% of patients were married, 42.1% had a diploma education, and 11.4% had a history of taking neuropsychiatric drugs. Also, 42.9% of patients were covered by social security insurance. The highest rate of self-discharge was in the evening (42.1%) and night (37.9%) shifts. The most important reasons for self-discharge decision were problems related to insurance (30%), COVID-19 infection (26.4%), poor communication (17.1%), dissatisfaction with care (15.7 %), disrespectful behavior of staff (12.9%), and inappropriate emergency ward facilities (12.1%).
Conclusion Make appropriate decisions to improve the quality of medical services and increase cooperation in health insurance, separating the departments of infectious diseases away from other departments, holding briefing sessions for physicians and medical staff, increasing awareness of patients about possible complications of self-discharge, and improving the amenities of emergency ward can reduce the rate of self-discharge decision.
Review Paper: Research |
Subject:
General
Received: 2023/08/5 | Accepted: 2024/01/20 | Published: 2024/07/1
Received: 2023/08/5 | Accepted: 2024/01/20 | Published: 2024/07/1
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