Evaluation of causes and outcomes of discharge with the personal consent of patients admitted to Shahid Motahari Educational and Medical Center, Urmia, ۲۰۲۴

Background: Discharge with the personal consent represents a critical indicator of hospital inefficiency, in which a patient leaves the hospital before completing the prescribed course of treatment despite medical advice. This may result in serious consequences, including adverse treatment outcomes, patient dissatisfaction, legal challenges for healthcare providers, hospital readmission, disease relapse, and even death. The aim of this study was to investigate the causes and consequences of discharge with the personal consent among hospitalized patients in Shahid Motahari Educational and Medical Center, Urmia, in ۲۰۲۴. Methods: This descriptive cross-sectional study included children who were admitted to Shahid Motahari Educational and Medical Center during ۲۰۲۴ and were discharged with the personal consent by their parents. Data were collected using a standardized three-part questionnaire provided by the Deputy of Treatment Affairs. The first section included demographic information, the second section identified the reasons for the personal consent, and the third section examined the resulting consequences. Data were analyzed using SPSS version ۱۶. Results: The findings showed that the rate of the personal consent in pediatric wards was ۴%, which is two percentage points higher than the global index. The most common reasons were perceived recovery (۵۸.۷۳%), prolonged hospitalization (۸%), father's occupation (۶%), fear of treatment (۳.۷۵%), lack of medical decision-making and dissatisfaction with insufficient physician attention (۳.۵% each). The least common reasons were ward overcrowding (۱.۱۷%) and lack of welfare facilities (۱.۵%). Analysis revealed that ۶۰% of the personal consent were due to parental decisions, while ۴۰% were related to hospital processes and resources. Regarding outcomes, ۲۶.۴% of patients sought care in other centers, ۲۴.۲۶% were readmitted to the same hospital, and ۱۰% died. Conclusion: The most common reason for the personal consent was the parents' perception of relative recovery in their children. Strengthening effective communication, increasing parents' awareness of potential risks, and improving the quality of medical and nursing services are key strategies for reducing the personal consent.