ترک با مسئولیت شخصی و عوامل مؤثر بر آن در بیماران مراجعه کننده به مرکز آموزشی درمانی ضیائیان

Background: Decision to stop or continue the treatment after awareness about complications and risks is patients' rights. On the other hand, patient`s discharge against medical advice could threaten patients' health. This study aimed to determine the causes of patient`s discharge against medical advice to prevent negative effects on patients and health costs. Materials and Methods: In this study, 342 patients who left hospitals regarding discharge against medical advice were enrolled. Up to 48 hours of leaving hospital, the patients were received telephone contact, and if consented, were asked about the potential causes and whether or not the explanation of nurses or physician about the risks and side effects of discharge against medical advice. Furthermore, causes of discharge against medical advice were categorized as patient, hospital condition and combined causes. Results: Study findings revealed that 48.5% of patients with personal reasons, 26% because of dissatisfaction with the service and 25.5% due to a combination of causes left the hospital. Most of the patients were in emergency department (p<0.001). There was relationship between type of disease (p= 0.037) and referred shift of patients (p=0.002) with type of discharge. Conclusion: Given to the study results, it seems that planning for providing and maintaining human resources, training staff especially new entrance, monitoring medical team performance and organizing the triage system are essential in patient`s discharge against medical advice.