Study of patients absconding behavior in a general hospital at southern region of Iran

Abstract

Background: Patients' escape from hospital imposes a significant cost to patients as well as the health system. Besides, for these patients, exposure to adverse events (such as suicide, self-harm, violence and harm to hospital reputation) are more likely to occur compared to others. The present study aimed to determine the characteristics of the absconding patients in a general hospital through a case-control design in Shiraz, Iran. Methods: This case-control study was conducted on 413 absconded patients as case and 413 patients as control in a large general hospital in Shiraz, southern Iran. In this study, data on the case and control patients was collected from the medical records using a standard checklist in the period of 2011-3. Then, the data were analyzed using descriptive and analytical statistics, through SPSS 16. Results: The finding showed that 413 patients absconded (0.50%) and mean of age in case group was 40.98 ± 16.31 years. In univariate analysis, variables of gender [Odds Ratio (OR)= 2], ward (OR= 1.22), insurance status (OR= 0.41), job status (OR= 0.34) and residence expenditure were significant. However, in multivariate analysis significant variables were age (OR adj = 0.13), gender (OR adj = 2.15), self-employment/unemployed (OR adj = 0.47), emergency/admission (OR adj = 2.14), internal/admission (OR adj = 3.16), insurance status (OR adj = 4.49) and residence expenditure (OR adj = 1.15). Conclusion: Characteristics such as middle age, male gender, no insurance coverage, inability to afford hospital expenditures and admission in emergency department make patients more likely abscond from the hospital. Therefore, it may be necessary to focus efforts on high-risk groups and increase insurance coverage in the country to prevent absconding from hospital.

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

“…Patient absconding is defined as leaving a medical center without permission from service providers (2), which can pose risks to patients, their families, and hospital staff. The potential consequences of patient absconding include self-harm, suicide, violence, harm to others, self-neglect, death, treatment disruption, lengthened recovery, and stigmatized reputation of the hospital and health system (3)(4)(5)(6).…”

“…Patient absconding can lead to an increase in the workload of hospital staff and security and add to the required measures for returning the patient (8). Hospitals, as well as the staff, may also encounter legal problems in case of harm to the patients (9).…”

“…The rate of patient absconding in various studies has been estimated at 2.5% -34% in psychiatric hospitals (12) and 0.27% -2.4% in general hospitals (1,3,13,14). Studies have shown that absconding is common among young individuals, men, drug addicts, patients admitted to emergency departments (ED), and those with imprisonment experiences (3,(12)(13)(14)(15)(16)(17).…”

“…Studies have shown that absconding is common among young individuals, men, drug addicts, patients admitted to emergency departments (ED), and those with imprisonment experiences (3,(12)(13)(14)(15)(16)(17). In various studies, it has been shown that absconding occurs more frequently during warm seasons.…”

“…The causes of patient absconding include fear, homesickness, irritation, concerns about family responsibilities, delayed medical examinations and treatments, treatment costs, lack of insurance coverage, lack of information about the disease, and mental disorders (3,15,(17)(18)(19). According to a study by Handel et al, reducing the waiting time for patients and informing them about the approximate waiting time can dissipate the number of escapes (20).…”