STUDYING THE RATE AND CAUSES OF BEING DISCHARGED AGAINST MEDICAL ADVICE IN INPATIENT AND OUTPATIENT WARDS OF SHAHID MADANI HOSPITAL IN KHOY CITY, 2014

Being discharged on the contrary to the medical advice from the hospital can
cause the premature discontinuation of treatment by patients or their family, and sometimes it results in
the re-hospitalization or death of patients. It can be a detector of serious problem and patient
dissatisfaction. This study aimed to assess the rate and causes of discharge against medical advice in
inpatient and outpatient wards of Shahid Madani hospital in khoy.
Materials & Method: This cross-sectional study was performed in Shahid Madani hospital in khoy city
in 2014. All of inpatient and outpatient (1663 patients) that discharged the hospital against medical
advice during the study period were included in the study. Data collection tool was a check list. Data
were analyzed by using descriptive and inferential statistics in SPSS 18.
Results: The patients, who were discharged from the hospital against medical advice, were 6/82% of all
inpatients and 19/65% of all outpatients in emergency ward. The most important reason for discharging
(47/8%) was prolongation of hospital stay. Other reasons were listed as feeling better, tending to stay in
the hospital medical center, denial of treatment, dissatisfaction with the doctor, lack of facilities,
dissatisfaction with the service provider and end stage of the patient.
Conclusion: As far as being discharged against medical advice can disrupt the patient's treatment, so it
is advised to prevent it by increasing the patients awareness to the possible effects of illness, planning a
better treatment protocol for patients, stabilizing the clinical social workers to identify and assessing the
patient’s problems, creating a better space to relax patients and their relatives, and by creating a pleasant
environment.