Patient Absconding and Its Predictors: A 5-Year Retrospective Analysis in a General Teaching Hospital in Tehran, Iran

Anisi, Somayeh; Zarei, Ehsan; Kariman, Hamid; Kazemi, Mohammad Kazem; Chehrazi, Mohammad

doi:10.5812/semj.14532

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…For instance, the highest rate of absconsion (54.4%) in all the included studies was reported among forensic patients managed in a nonforensic general psychiatric unit in Malawi 42 . Compared to the present study, relatively lower rates of absconsion have been reported in reviews of studies conducted in general psychiatric units, with an average of 12.6%1 (range: 2%-44%), 1 , 58 and the rates in nonpsychiatric general hospitals ranged between 0.27% and 2.4% 59 . While a comparative study on absconsion is currently limited due to the methodological issues outlined earlier (eg, variability in construct, study duration, and contextual factors), it is conceivable that higher rates of absconsion are possible in forensic patients due to unique risk issues described above, especially if they are managed in nonsecure units 42 , 43 .…”

Section: Discussioncontrasting

confidence: 74%

Absconsion in forensic psychiatric services: a systematic review of literature

et al. 2020

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While serious concerns are often raised when patients abscond or leave unauthorized from psychiatric services, there is limited knowledge about absconsion in forensic psychiatric services. Following the preferred reporting items for systematic reviews and meta-analyses guideline, we searched Medline/PubMed, PsycINFO, EMBASE, CINAHL, Scopus, and Web of Science through May 2020 for eligible reports on absconsion in forensic patients with no language limits. The search string combined terms for absconsion, forensic patients, and psychiatry in various permutations. This was supplemented by snowball searching for additional studies. Of the 565 articles screened, 25 eligible studies, including two interventional, seven cross-sectional, and 16 case-controlled studies spanning five decades were included. Absconsion and re-absconsion rates ranged from 0.2% to 54.4% and 15% to 71%, respectively, albeit higher rates trended with less secure psychiatric units. Previous absconsion, aggression, substance use, high Historical Clinical Risk Management-20 score, anti-sociality, psychiatric symptoms, sexual offending, and poor treatment adherence were the factors reported with a degree of predictive value for absconsion. However, the construct of absconsion was heterogeneous in the included studies and the quality of evidence on the predictors of absconsion was limited. Serious risky behaviors including re-offending, violence, self-harm, suicide, rape, and manslaughter were perpetrated by patients during unauthorized leave. Nevertheless, the rates of re-offending were generally low in the included studies (highest recidivism rate = 0.11). There is need for standardized assessment and documentation of absconsion to improve risk analysis and management. Furthermore, it is necessary to develop a structured guideline for defining absconsion, and to create a protocol that operationalizes all absconsion-related behaviors/events to promote reliable assessment and comparative analysis in future studies.

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Section: Discussioncontrasting

confidence: 74%

Absconsion in forensic psychiatric services: a systematic review of literature

et al. 2020

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“…The most important reasons can be due to fatigue and hopelessness, intolerance of hospital, overdose of drugs, addiction, and poisoning, drinking alcoholic drinks, treatment failure, behavioral disorders, unemployment, and receiving unpleasant news [ 5 ]. However, the most important reason for patients to escape from general hospital is the inability to pay the medical costs, which has been mentioned in some studies [ 6 , 7 ]. According to research, absconders are typically young, male, and have been diagnosed with schizophrenia [ 8 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

The reasons why patients abscond from public hospitals in southeastern Iran: a qualitative study

et al. 2021

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Background Patient absconding from hospital is one of the permanent issues the hospitals face, which poses many risks and challenges to the patient, hospital, and society. The present study aimed to identify the reasons for patient absconding behavior for public hospitals in southeastern Iran. Methods The present study is a qualitative study which was conducted at three public hospitals in southeastern Iran using purposive sampling through semi-structured interviews with 63 informants involved in patient treatment process. Data were analyzed using Colaizzi content analysis (CCA) method. Results Three main themes of economic, social factors, and factors related to the hospital covering 15 subthemes were identified to explain the reasons for patients absconding behavior. Conclusion There are many reasons for reducing patients absconding from hospitals, and one of the main reasons is the patients’ economic and social problems. The absconding behavior can lead to harm and problems for patients, and some emotional and occupational consequences for the employees and nurses. Paying attention to this issue and considering some courses of action to prevent patient absconding might lead to a considerable promotion of public trust and eliminate many problems for hospitals.

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“…The most important reasons can be due to fatigue and hopelessness, intolerance of hospital, overdose of drugs, addiction, and poisoning, drinking alcoholic drinks, treatment failure, behavioral disorders, unemployment, and receiving unpleasant news [5]. However, the most important reason for patients to escape from general hospital is the inability to pay the medical costs, which has been mentioned in some studies [6,7]. This behavior can pose many risks, including longer recovering process or uncompleted treatment [8].…”

Section: Introductionmentioning

confidence: 99%

The Reasons Why Patients Abscond From Public Hospitals in Southeastern Iran: a Qualitative Study

Moradpour

Amiresmaili

Moghadam

et al. 2020

Preprint

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Background: Patient absconding from hospital is one of the permanent issues the hospitals face, which poses many risks and challenges to the patient, hospital, and society. The present study aimed to identify the reasons for patient absconding behavior for public hospitals in southeastern Iran. Methods: The present study is a qualitative study which was conducted at three public hospitals in southeastern Iran using purposive sampling through semi-structured interviews with 63 informants involved in patient treatment process. Data were analyzed using Colaizzi content analysis (CCA) method. Results: Three main themes of economic, social factors, and factors related to the hospital covering 15 subthemes were identified to explain the reasons for patients absconding behavior. Conclusion: There are many reasons for reducing patients absconding from hospitals, and one of the main reasons is the patients’ economic and social problems. The absconding behavior can lead to harm and problems for patients, and some emotional and occupational consequences for the employees and nurses. Paying attention to this issue and considering some courses of action to prevent patient absconding might lead to a considerable promotion of public trust and eliminate many problems for hospitals.

show abstract

Patient Absconding and Its Predictors: A 5-Year Retrospective Analysis in a General Teaching Hospital in Tehran, Iran

Cited by 4 publications

References 19 publications

Absconsion in forensic psychiatric services: a systematic review of literature

Absconsion in forensic psychiatric services: a systematic review of literature

The reasons why patients abscond from public hospitals in southeastern Iran: a qualitative study

The Reasons Why Patients Abscond From Public Hospitals in Southeastern Iran: a Qualitative Study

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