Patient absconding from emergency department and its financial burden: a study in a large public hospital, Tehran
Journal of Health in the Field,
,
10 February 2017
چکیده
Background and Aims: Patient absconding is a major health issue with economic, social, and health costs and consequences. The present study aimed to investigate the absconding rate from a emergency department and its financial burden in a public hospital in Tehran, IRAN.Materials and Methods: This retrospective and descriptive study was carried out in the emergency department of a large public and teaching hospital in Tehran. Data were collected using the absconded patient records from 23 September 2013 to 22 September 2014. Data were analyzed using descriptive statistics.
Concerns about medical ethics, including patient’s confidentiality and hospital name were observed at all stages of study.
Results: The results of this study indicate that 774 patients had left the hospital without permission or a notice to staff, so the absconding rate in this study was about 2.4 percent. Young, male, married and uninsured patients were more absconded. Average billing per absconded patient was 1,449,738 Iranian Rials (IRR). The hospital was consequently incurred financial losses amounted to 1,122,097,212 IRR as a result of patient
absconding.
Conclusion: In order to preventing and reducing the abscond rate, the following strategies are recommended: the identification of high-risk patients for further care, regular monitoring of emergency departments, good communication and interaction with the patient and his family, introducing the discharge against medical advice (DAMA) policy to patients, accurate recording of patient information to reduce the risk of abscond or
access to him/her after the absconding.
Key words: Patient Absconding, Emergency Department, Retrospective Study
*Corresponding
مراجع
Muir-Cochrane E, Mosel KA. Absconding: A review of the literature 1996–2008. International Journal of Mental Health Nursing 2008;17(5):370-78.
Khammarnia M, Kassani A, Amiresmaili M, Sadeghi A, Jaberi ZK, Kavosi Z. Study of patients absconding behavior in a general hospital at southern region of Iran. International Journal of Health Policy and Management 2015; 4(3):137-41.
Wilkie T, Penney SR, Fernane S, Simpson AI. Characteristics and motivations of absconders from forensic mental health services: a case-control study. BMC Psychiatry 2014;14(1):91.
James F, Catherine H. CEC Best Practice guideline – The Patient who Absconds. London: The College of Emergency Medicine; 2013.
Ajalli A, Khodaee M, Goodarzi M, Tamizi Z, Dibaee M. Assessment of relationship between characteristics of psychiatric patients escaping from Razi Psychiatric Hospital. Iranian Journal of Psychiatric Nursing 2015;
(4):59-67 (In Persian).
Memarian A, Yazdinezhad SR, Mehrpisheh S, Aghakhani K. Characteristics of absconders from a general health service, Rasoul Akram Hospital in 2013. Polish Annals of Medicine 2015; 22(2):82-85.
Cheng S, Chung C, Leung Y, Lai K. Patient absconding behaviour in a public general hospital: retrospective study. Hong Kong Medical Journal 2002; 8(2):87-91.
Kasmi Y, Brennan D. Developing a patient leave request form for a secure setting. Mental Health Practice 2015; 18(5):30-35.
Simpson AI, Penney SR, Fernane S, Wilkie T. The impact of structured decision making on absconding by forensic psychiatric patients: results from an AB design study. BMC Psychiatry 2015; 15(1):103.
Stewart D, Bowers L. Absconding from psychiatric hospitals: a literature review. London: Institute of Psychiatry; 2010.
Sheikhmoonesi F, Kabirzadeh A, Yahyavi ST, Mohseni B. A prospective study of patients absconding from a psychiatric hospital in Iran. Med Glas 2012; 9(2):345-49.
Khammarnia M, Kavosi Z, Karimi Jaberi Z, Shirvani M, Sadeghi A. Investigation of the rate of patients escape from a general hospital in Shiraz, Iran. Sadra Medical Sciences Journal 2014; 2:65-74 (In Persian).
Khisty N, Raval N, Dhadphale M, Kale K, Javadekar A. A prospective study of patients absconding from a general hospital psychiatry unit in a developing country. Journal of Psychiatric and Mental Health Nursing
; 15(6):458-64.
Mosel KA, Gerace A, Muir-Cochrane E. Retrospective analysis of absconding behaviour by acute care consumers in one psychiatric hospital campus in Australia. International Journal of Mental Health Nursing
;19(3):177-85.
Gerace A, Oster C, Mosel K, O'Kane D, Ash D, Muir-Cochrane E. Five-year review of absconding in three acute psychiatric inpatient wards in Australia. International Journal of Mental Health Nursing 2015; 24(1):
-37.
- چکیده مشاهده شده: 1163 بار
- PDF (English) دانلود شده: 326 بار