Prevalence and causes of patient self discharge against medical advice in children of Boo-Ali Hospital in Sari in 2009

Self discharge against medical advice is a challenge facing health systems in the world. Since children play no role in deciding for self-discharge against medical advice, this study aimed at determining the rate and causes of discharge against medical advice. This is a descriptive, cross sectional chart review study without sampling. To determine the relationship between variables the x2 statistics were used. Data were analyzed using SPSS software and the value of P<0.05 was considered significant. Results showed the rate of discharge against medical advices to be (2.2%) (108).The children’s median age was 2 and their length of stay in hospital 2 days. A total of 95 patients (88.7%) had insurance. Among the children under study 65 (60.2%) were citizens of Sary and 22(20.6%) of the patients had a negative history of addiction or psychiatric disease. 100 (92.3%) patients were hospitalized for nonsurgical reasons and the remainder were hospitalized for surgical reasons. For 72.3% of the children their father had signed the discharge on behalf of the children. Of the 108 patients discharged against medical advice, 20 (12%) were readmitted. The relationship between the day of discharge and discharge against medical advice was significant (P-value=0.03). Discharge against medical advice in Boo-Ali hospital showed similar rates with other linear studies. Of significance is also the absence of a suitable form explaining to parents the possible outcomes of self-discharge against medical advice and the failure to record the real cause of such discharges.