EPA-0055 - Patients discharged against medical advice from a psychiatric hospital in iran: a prospective study

Abstract

Aims Prevalence of discharge against medical advice in psychiatric populations ranges from 3 to 51 percent which has increased over the past 50 years. We intended to find the proportion of patients who leave hospital against medical advice and explore some of their characteristics. Materials and Methods This prospective study of discharge against medical advice was conducted in psychiatric wards of Zare hospital in Iran, 2011. A psychologist recorded some information on a checklist based on the documented information about the patient who were willing to leave against medical advice. The psychologist interviewed these patients and recorded the reasons for discharge against medical advice. Descriptive statistics were calculated for the variables. Results The rate of premature discharge was 34.4%. Compared to patients with regular discharges, patients with premature discharge were significantly more likely to be male, self-employed, to have co morbid substance abuse and previous hospitalizations and positive family history of psychiatric disorder. Disappearance of symptoms was the most frequent reason for premature discharge. Conclusion The 34.4% rate of premature discharge observed in our study is higher than average reported in other studies. One possible explanation is our teaching hospital serves a low-income urban area and most patients had low socioeconomic status. Further studies are needed to compare teaching and non-teaching hospital about the rate of premature discharge and the reasons of patients who want to leave against medical advice.