Patient Absconding and Its Predictors: A 5-Year Retrospective Analysis in a General Teaching Hospital in Tehran, Iran

Background and Patient absconding from a hospital or leaving without permission is a major challenge with economic and social consequences for patients, healthcare staff, and society. Identification of the characteristics of absconding patients is essential to the prediction and prevention of such behaviors.
This cross sectional study was performed in a large general teaching hospital in Tehran, Iran. Data of 460 absconding patients and 460 nonabsconding patients, admitted during March 2010 - March 2016, were extracted from the hospital information system. Backward stepwise logistic regression analysis was used to describe the importance and effect of each predictor.
The findings showed that 0.4% of the patients had left the hospital without permission or notice to the staff. Addiction (OR, 27.15), lack of insurance coverage (OR, 12.39), male gender (OR, 2.14), age ≤ 40 years (OR, 1.89), and emergency admission (OR, 1.77) were predictors of absconding. Hospital financial loss amounted to 3,818,788,624 IRR ($126,283) due to this problem, with an average cost of 7,178,174 IRR ($237) per patient.
Identification of high-risk individuals, including young men, uninsured patients, and drug addicts with emergency admission warrants preventive measures. Moreover, assessment of patients by physicians or nurses upon admission, staff training and raising awareness, and use of technologies such as radiofrequency identification can be other strategies for preventing or reducing this problem.