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Groohi-sardou S, Anaei Goudari A, Rahmanian V, Faryabi R, Ghasemian N, Goroei Sardou E et al . Patient-initiated discharge from emergency departments and the related factors in Jiroft, South of Iran. JHNM 2026; 36 (1) :46-53
URL: http://hnmj.gums.ac.ir/article-1-2280-en.html

Introduction: Patients’ self-discharge may indicate dissatisfaction with healthcare services. In some cases, it can lead to re-hospitalization or even the death of the patient.
Objective: This study aimed to investigate the reasons for patient-initiated discharge from the emergency department of a teaching hospital in Jiroft, south of Iran.
Materials and Methods: This cross-sectional/analytical study was conducted in 2022 on 341 patients discharged by personal consent from the emergency department of a teaching hospital affiliated with Jiroft University of Medical Sciences, who were selected using a census method. To collect data, a checklist was used. The data were analyzed using descriptive statistics, chi-square test, and logistic regression analysis to identify the factors associated with self-discharge. P<0.05 was considered statistically significant.
Results: The mean age of the participants was 36.65±19.3 years and 52.7% were male. The most common reasons for self-discharge included dissatisfaction with diagnostic/therapeutic measures and medical/nursing services provided (31.4%), and prolongation of hospitalization and delayed surgery or treatment (18.5%). The common hospital-related reasons included dissatisfaction with the physical space or environment (22.3%), lack of available ICU beds (26.7%), malfunction of medical equipment (13.5%), inappropriate accommodation of patient companions (19.6%), improper feeding (25.8%), and poor cleanliness status (25.2%). Based on the logistic regression model, significant predictors of self-discharge included family-related problems (OR=2.45, 95% CI; 1.62%, 3.7%, P=0.001), dissatisfaction with diagnostic and therapeutic measures (OR=1.88, 95% CI; 1.20%, 2.96%, P=0.005), lack of available ICU beds (OR=1.67, 95% CI; 1.05%, 2.65%, P=0.03), and night-shift discharge (OR=1.93, 95% CI; 1.20%, 3.11%, P=0.007).
Conclusion: The self-discharge of patients from emergency departments in Iran is because of patient-related, staff-related, and hospital-related conditions, including family problems, dissatisfaction with care quality, lack of ICU beds, and night-shift discharge. Hospital managers should focus on these factors to improve patient satisfaction and reduce self-discharge rate.