464 – A prospective study of patients absconding from a psychiatric hospital in Iran

Sheikhmoonesi, Fatemeh; Kabirzadeh, A; Yahyavi, Seyyed Taha; Saravi, Benyamin Mohseni

doi:10.1016/s0924-9338(13)75790-0

Cited by 7 publications

(16 citation statements)

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“…The rate of absconding in this hospital was low (0.50%), which was similar to studies conducted in other general hospitals (0.30%) (12). These rates are significantly lower than psychiatric hospitals or psychiatric wards (5,12,13). For example, the absconding rate was reported about 13.33% in psychiatric wards in Australia (14) and 14.21% in India (a non-industrial country) (15).…”

Section: Discussionsupporting

confidence: 84%

“…In addition, some cases in the United States have been described that subsistence expenditure was the main cause of absconding (10). Some studies conducted in psychiatric hospitals in Iran have revealed that risk of absconding is higher in male and single patients (6) and in the early days of admission (5). However, we were unable to find research regarding the absconding from general hospital and the characteristics of absconders in Iran.…”

Section: Introductionmentioning

confidence: 79%

“…Patient absconding causes additional costs to the hospital and the patient. These include increased responsibility and workload of hospital staff, the executive manager, and the police department to return the patient to the hospital (5,6). The risks associated with absconding provide a compelling reason to develop tools and strategies to identify potential absconders (6).…”

Section: Introductionmentioning

confidence: 99%

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

Khammarnia

Kassani

Amiresmaili

et al. 2014

Int J Health Policy Manag

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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.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Khammarnia

Kassani

Amiresmaili

et al. 2014

Int J Health Policy Manag

View full text Add to dashboard Cite

show abstract

“…The authors carried out a study about patients absconding from Zare hospital. In that study we found absconding was more frequent in summer ( Sheikhmoonesi, Kabirzadeh, Yahyavi, & Mohseni, 2012 ).…”

Section: Discussionmentioning

confidence: 64%

Patients Discharged Against Medical Advice from a Psychiatric Hospital in Iran: A Prospective Study

Sheikhmoonesi¹,

Khademloo²,

Pazhuheshgar³

2014

GJHS

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Aim:Self- discharged patients are at high risk for readmission and ultimately higher cost for care. We intended to find the proportion of patients who leave hospital against medical advice and explore some of their characteristics.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 wanted 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 first admission 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 rate 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.

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“…For others, absconding was reflective of goal-directed behavior, either to complete a task (e.g., related to household responsibilities) or to obtain substances. A recent study of psychiatric patients who absconded in Iran found similar motivational themes, including feelings of boredom as well as missing family members [ 15 ]. Few studies have found evidence of symptom-driven motivation when patients are asked directly about their reasons for absconding (e.g., [ 14 ]); however, fear and safety concerns were noted to play a significant role in patients’ decisions to abscond, as were failures in the therapeutic relationship with staff [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of structured decision making on absconding by forensic psychiatric patients: results from an A-B design study

et al. 2015

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BackgroundFew studies have investigated absconding from forensic hospitals and there are no published studies of interventions aimed at reducing these incidents in forensic settings. We present a study of the impact of a new policy using structured professional judgment and an interdisciplinary team-based approach to granting privileges to forensic patients. We assess the impact of this policy on the rate and type of absconding from a metropolitan forensic facility.MethodsFollowing concern about the rate of absconding at our hospital, a new policy was implemented to guide the process of granting hospital grounds and community access privileges. Employing an A-B design, we investigated the rate, characteristics, and motivations of absconding events in the 18 months prior to, and 18 months following, implementation of this policy to assess its effectiveness.ResultsEighty-six patients were responsible for 188 incidents of absconding during the 42-month study window. The rate of absconding decreased progressively from 17.8% of all patients at risk prior to implementation of the new policy, to 13.8% during implementation, and further to 12.0% following implementation. There was a differential impact of the policy on absconding events, in that the greatest reduction was witnessed in absconsions occurring from unaccompanied passes; this was offset, to some extent, by an increase in absconding occurring from within hospital units or from staff accompanied outings. Seven of the absconding events included incidents of minor violence, and two included the commission of other illegal behaviors. The most common reported motive for absconding across the time periods studied was a sense of boredom or frustration. Discharge rate from hospital was 22.9% prior to the implementation of the policy to 22.7% after its introduction, indicating no change in the rate of patients’ eventual community reintegration.ConclusionsA structured and team-based approach to decision making regarding hospital grounds and community access privileges appeared to reduce the overall rate of absconding without slowing community reintegration of forensic patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-015-0474-1) contains supplementary material, which is available to authorized users.

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464 – A prospective study of patients absconding from a psychiatric hospital in Iran

Cited by 7 publications

References 0 publications

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

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

Patients Discharged Against Medical Advice from a Psychiatric Hospital in Iran: A Prospective Study

The impact of structured decision making on absconding by forensic psychiatric patients: results from an A-B design study

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