Investigating the Reasons of Discharge With the Personal Consent of Patients Admitted to the Emergency Ward of Kowsar Hospital in Semnan City, Iran

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 decisi...

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Main Authors: Mehdi Yarahmadi, Mehri Ayati, Mohammad Taghi Ghorbanian
Format: Article
Language:fas
Published: Guilan University of Medical Sciences 2024-06-01
Series:مجله دانشگاه علوم پزشکی گیلان
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Online Access:http://journal.gums.ac.ir/article-1-2627-en.pdf
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author Mehdi Yarahmadi
Mehri Ayati
Mohammad Taghi Ghorbanian
author_facet Mehdi Yarahmadi
Mehri Ayati
Mohammad Taghi Ghorbanian
author_sort Mehdi Yarahmadi
collection DOAJ
description 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.
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spelling doaj-art-1f44f4a8eb514cb8b884dab314f8b2cb2025-08-20T03:08:00ZfasGuilan University of Medical Sciencesمجله دانشگاه علوم پزشکی گیلان2008-40482008-40562024-06-01332188201Investigating the Reasons of Discharge With the Personal Consent of Patients Admitted to the Emergency Ward of Kowsar Hospital in Semnan City, IranMehdi Yarahmadi0Mehri Ayati1Mohammad Taghi Ghorbanian2 Department of Emergency Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. Department of Pediatrics, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. Department of Emergency Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. 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.http://journal.gums.ac.ir/article-1-2627-en.pdfdischargepersonal satisfactionhospitalemergency ward
spellingShingle Mehdi Yarahmadi
Mehri Ayati
Mohammad Taghi Ghorbanian
Investigating the Reasons of Discharge With the Personal Consent of Patients Admitted to the Emergency Ward of Kowsar Hospital in Semnan City, Iran
مجله دانشگاه علوم پزشکی گیلان
discharge
personal satisfaction
hospital
emergency ward
title Investigating the Reasons of Discharge With the Personal Consent of Patients Admitted to the Emergency Ward of Kowsar Hospital in Semnan City, Iran
title_full Investigating the Reasons of Discharge With the Personal Consent of Patients Admitted to the Emergency Ward of Kowsar Hospital in Semnan City, Iran
title_fullStr Investigating the Reasons of Discharge With the Personal Consent of Patients Admitted to the Emergency Ward of Kowsar Hospital in Semnan City, Iran
title_full_unstemmed Investigating the Reasons of Discharge With the Personal Consent of Patients Admitted to the Emergency Ward of Kowsar Hospital in Semnan City, Iran
title_short Investigating the Reasons of Discharge With the Personal Consent of Patients Admitted to the Emergency Ward of Kowsar Hospital in Semnan City, Iran
title_sort investigating the reasons of discharge with the personal consent of patients admitted to the emergency ward of kowsar hospital in semnan city iran
topic discharge
personal satisfaction
hospital
emergency ward
url http://journal.gums.ac.ir/article-1-2627-en.pdf
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