Factors Affecting Discharge Against Medical Advices: A Case-Control Study in a Treatment-Teaching Hospital
Journal Title: مجله راهبردهای مدیریت در نظام سلامت - Year 2017, Vol 2, Issue 1
Abstract
Background: Discharge against medical advices is leaving hospital despite medical advice, which can be a sign of the patient's dissatisfaction and a significant challenge for health system managers. This study examined the reasons for discharge against medical advices and compared the results with the control group (discharge with the doctor's opinion). Methods: The present study is a case-control study in which 280 samples were selected randomly in two groups of patients discharged against medical advices and those who discharged with doctor's opinion. Data were collected through the questionnaire measuring patient-companion satisfaction in different wards of the hospital. Data were then analyzed using Chi-square and linear regression tests by SPSS 16 software. Results: Results showed that patient's age, having basic and complementary insurance, day of referring to hospital, education, and occupation made significant differences between the two groups. Among these factors, the most effective ones for discharge against medical advice were basic insurance (p = 0.020), age (p = 0.020), and occupation (p = 0.030). The most important reasons for discharge against medical advice from patients' viewpoints were failure to determine the patient's status, personal problems, feeling relative relief and partial recovery, as well as lack of physicians' considerations in that hospital. Conclusion: It seems that patients decide to discharge against medical advices due to lack of necessary supervision over the performance of medical and nursing services, and also lack of motivation in personnel to prevent from this event. In order to earn patients' satisfaction, managers are required to improve the hospital's services. Key words: Patient's satisfaction, Hospital, Patient
Authors and Affiliations
Zhila Najafpour, Mohamad Reza Jafari, Maryam Hatamizadeh, Sousan Rahimi, Zahra Bigdeli, Abbas Homauni
Modeling the Effective Management Factors in the Pattern of Regulation and Supervision of Social Insurance Funds of Iran
Background: To achieve the objectives of social security and health system, it is essential to enhance the level of efficiency of social insurance funds. To hit this target, the challenges of regulation improvement shoul...
Evaluating the Average Waiting Time for an Emergency Medicine Specialist Visit in an Emergency Department: A Case Study
Background: One of the dimensions of healthcare quality is providing care without delay, in a timely manner and without a long waiting time. The aim of this study was evaluating the average waiting time for an emergency...
The Viewpoints of Medical Students in Acquiring Management, Educational and Individual Skills after Passing the Community Medicine Courses
Background: One of the main concerns of policy makers and planners in the field of education and health has been to measure achievement of goals. The purpose of this study was to investigate the effect of a one-month cou...
Identifying the Succession Dimensions and Formulating the Health Network Managers' Selection Components
Background: Management transport occurs in organizational hierarchy commonly; so, succession planning is of a great importance. In this regard, identification of the effective methods for succession planning leads to org...
Investigating the Relationship of Study and Learning Strategies with the Level of Test Anxiety among Students of Yazd University of Medical Sciences in 2016
Background: Test anxiety is a common problem among students. Applying the learning and studying strategies to deal with anxiety disorder can improve students' academic performance. The purpose of this study was to inves...