Factors Influencing Discharge against Medical Advice in InternalMedicine and Surgical Wards: A Study at a Hormozgan UniversityHospital in 2023
نویسندگان
1 Associate Professor of Health Services Administration, Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences
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چکیده
Background and Objective: Early discharge against medical advice can elevate health risks and costsdue to potential readmissions. Understanding contributing factors and implementing timely interventionscould reduce early discharge incidence. This study explores reasons behind patients' decisions to leave aHormozgan University of Medical Sciences hospital prematurely based on personal preference in 2023.Materials & Methods: This descriptive-analytical, cross-sectional study enrolled 42patients (or their companions) from internal medicine and surgical departments who completed dischargeagainst medical advice forms in the third quarter of 2023. Following informed consent, telephone interviewsusing a researcher-developed questionnaire were conducted. Data were analyzed using SPSS version 27 withdescriptive and analytical statistics (Mann-Whitney U test, independent T-test; P < 0.05).Results: The most frequent reasons for early discharge were: fatigue from hospital stay 16 (38.09%),feeling of recovery 15 (35.71%), inadequate hospital facilities 14 (33.33%), dissatisfaction with medicalservices 10 (23.81%), and physician-advised discharge at patient's request 9 (21.43%). No significantcorrelation was found between length of stay and discharge reasons. However, significant associationsemerged between readmission and reasons related to physicians (P = 0.002), equipment/hospitalenvironment (P = 0.001), and overall hospital status (P = 0.004).Conclusion: The fatigue experienced by patients and their companions as a result of extendedtreatment durations emerged as a significant factor contributing to early discharge. To effectively tackle thisissue, it is essential to provide healthcare staff with training focused on the development andimplementation of personalized treatment plans. Additionally, fostering a supportive atmosphere andoffering amenities for companions could play a crucial role in decreasing the rates of early discharge. Theinsights gained from this study can serve as a valuable resource for hospital administrators, enabling them topinpoint adjustable elements that can enhance the quality of care and minimize the likelihood ofreadmissions.
