Patient absconding behaviour in a public general hospital: retrospective study

ST Cheng, CH Chung, YH Leung, KK Lai
North District Hospital, Po Kin Road, Sheung Shui, Hong Kong: Accident and Emergency Department

OBJECTIVE. To identify characteristics of patients who abscond from general hospital wards, and to determine patient outcomes.

DESIGN. Retrospective study.

SETTING. In-patient wards of a public general hospital, Hong Kong.

SUBJECTS AND METHODS. Incident reports of 116 absconding episodes over a 20-month period from 1 November 1998 to 30 June 2000 were reviewed. Clinical characteristics, time and reason for absconding, destination of patient, outcomes, and adverse events were recorded.

RESULTS. The majority of patients who absconded were middle-aged males admitted through the Accident and Emergency Department to the specialty of Medicine. Most incidences occurred within 24 hours of admission while in the emergency admission wards. Twelve percent of incidents were due to repeat episodes of absconding. The most common clinical diagnoses given to this patient group were drug overdose, intoxication, and soft tissue injury. Known drug addicts (29.3%) formed a substantial proportion of the patient group. Forty-seven patients returned to the ward within a few hours, while a further nine (7.8%) re-attended the Accident and Emergency Department of the hospital within 4 days. Several adverse outcomes were recorded: one patient died following a fall from height and two patients committed criminal offences.

CONCLUSION. Patient absconding incidents are an important issue in hospital risk management. They can delay the delivery of appropriate medical treatment and may also lead to other adverse patient outcomes, in addition to potential medicolegal consequences.

Hong Kong Med J 2002;8:87-91

Key words: Hospitals, general; Inpatients; Patient dropouts; Risk management