Investigating the Causes of Discharge Against Medical Advice in the Emergency Department of Shahid Motahari Educational and Medical Center, Urmia, ۲۰۲۴

Introduction: Discharge against medical advice is not only one of the five priority indicators of the Ministry of Health, Treatment, and Medical Education for evaluating the performance of emergency departments, but also a global challenge that can lead to undesirable outcomes and complications. Therefore, this study aimed to investigate the causes of discharge against medical advice among patients admitted to the emergency department of Shahid Motahari Educational and Medical Center in Urmia in ۲۰۲۴. Methods: This descriptive cross-sectional study was conducted on pediatric patients who visited the emergency department of Shahid Motahari Educational and Medical Center in Urmia during ۲۰۲۴ and were discharged against medical advice by their parents. Data were collected using a two-part questionnaire issued by the Deputy of Treatment. The first part included demographic information, and the second part included the reasons for Discharge against medical advice. Data were analyzed using SPSS version ۱۶. Findings: The results showed that the discharged against medical advice rate in the emergency department was ۶.۶%, which is two percent higher than the global rate (۴%). According to the findings, the most common reasons for discharged against medical advice were referral to a subspecialty clinic (۵۵.۰۶%), perception of recovery (۲۸.۴۹%), referral to a more advanced medical center (۳.۹۷%), and continuation of treatment at home (۲.۱۹%). Personal problems (۱.۵%) and overcrowding in the emergency department (۰.۸۲%) were the least common reasons. Conclusion: Based on the findings, the majority of patient dissatisfaction was related to the received services or deficiencies in the service delivery process. Measures such as proper planning to improve key indicators in the emergency department are recommended in order to reduce the rate of discharge against medical advice.