General characteristics of patients who leave emergency department against medical advices after being examined

Abstract

Objectives: Patients with serious illnesses who leave emergency department (ED) without being treated or insufficiently treated burden both physicians and themselves. The aim of this study was to evaluate general characteristics of patients who leave ED against medical advice and to determine the causes and severity of their illnesses.
Materials and Methods: A retrospective chart was performed covering December 2006 to March 2007 including patients who were elder than 18 years and discharged with their own consent from the ED. The data were obtained from computerized database. The general characteristics of patients, severity of their illnesses according to The Canadian Emergency Department Triage and Acuity Scale (CTAS), and length of ED stay were recorded. The causes of leaving ED were determined from the discharge consent forms filled by patients before leaving ED.
Results: A total of 97 patients were included into the study. The patients who left the ED against medical advice after being examined by a physician composed 3.3% of all emergency cases. 54% of the patients were triaged as ‘urgent’. The mean age of the study patients was 48.6±12.5 years and 49% were male. Mean length of ED stay was 138±130 minutes. The most common reason for leaving hospital among patients with triaged as urgent was “refuse hospital admission or ED observation” and “refuse the treatment regimen” was the most common reason in non-urgent group.
Conclusion: Determining the causes of leaving ED against medical advises should contribute finding solutions to this issue.