普通儿科住院患者自动出院的原因分析

单中心回顾性调查2011年1月~2012年11月普通儿科住院患儿自动出院1 088例,自动出院率18.7%（1 088/5 827）,其主要原因集中在症状或体征改善、经济困难、家庭因素、依从性差、医患矛盾、疗效欠佳、病房环境差、转院治疗等.儿科住院患者选择自动出院是对医疗制度与管理、医疗水平、服务态度、沟通技巧、家庭背景、社会救助等因素的综合考量.做好社会、医疗机构和医疗制度三方面积极救助环节是改善医患矛盾、减少患儿自动出院的有效措施.

Causes and Countermeasures for Against-advice Discharge in Hospitalized Children from General Pediatrics

Retrospective review of causes of 1 088 against--advice discharge children from January 2011 to December 2012 in single--center general pediatrics. The rate of against--advice discharge was 18.7 % （1 088/5 827）. Its causes were focused mainly on improved symptoms and physical signs, economic difficulty, family factors, poor compliance, physician--patient conflicts, poor therapeutic effects, bad ward environment, transfer to another hospital and others, respectively. Against-- advice discharge in hospitalized children is a comprehensive evaluation of current medical system and medical management, treatment level, service attitude, communication skill, family background, and social attention et al. Positive medical aid among social commonweal, medical organizations and medical system for patients is an important measure in improving doctor--patient contradiction and decreasing against--advice discharge in hospitalized children.