Evaluation of causes and outcomes of discharge with the personal consent of patients admitted to Dr. Sheikh Hospital of Mashhad

The patient’s self-discharge from the hospital is a process in which the patient leaves the hospital voluntarily without completing the course of treatment, despite medical advice, and can indicate patient dissatisfaction and a significant challenge for health system managers. This study was conducted to investigate the causes and consequences of a patient's self-discharge from Dr. Sheikh Hospital as a referral center in the northeast of Iran.

All patients who were discharged with the personal consent from the hospital with personal consent between October 2014 and March 2015 were included in the study. A checklist was used to collect data. The patients' outcome was completed by telephone a week later. Finally, SPSS statistical software was used to evaluate the results.

Totally, 51 patients were included in this study. The leading causes of discharge with personal consent were including dissatisfaction with the physician and medical staff in 23 patients (45.1%), home care preference in 12 patients (23.5%), distance from the hospital in 5 patients (9.8%), teaching at the hospital in 3 patients (،5.9), the high cost of treatment in 3 patients (9 5.9), the overcrowding of the hospital in 3 patients (9 5.9) and the lack of specialist or diagnostic and therapeutic devices in 2 patients (3.9%). Also, in the study of patients' outcome, 21 patients (41.1%) referred to the doctor again, 18 patients (35.3%) continued treatment at home, 9 patients (17.7%) were readmitted and 2 patients (3.9%) died.

The most common cause of discharge with personal consent was dissatisfaction from the treatment team. Given that 3.9% of patients have died and a large number of patients have been re-referred to the doctor and be readmitted, it seems that justifying patients to refrain from self-discharge is in the patient's best interest.