Factors associated with refusal of hospital treatment at Odi District Hospital, Gauteng Province, South Africa

Abstract

Abstract

Background

Medical consultation entails shared doctor-patient decision making. However, in certain cases disagreement between the two parties may lead to patient refusal of hospital treatment (RHT). At Odi District Hospital, patients opted for RHT at the accident and emergency (A&E) department and in wards. The study aimed at determining factors related to the RHT.

Methods

This was a cross-sectional descriptive study of patient files with a record of RHT from 2017 to 2018. They were traced using the register books and 241 were obtained: A&E (160), obstetrics and gynaecology (2), internal medicine (24), orthopaedics (2), paediatrics (12) and surgery (41). Eighteen files were excluded for incomplete data, 223 remained for analysis.

Results

More males and the single signed RHT 139 (62.33%) and 152 (68.16%), respectively. RHT was frequent towards the end of the day (p = 0.041), at A&E (59.5%) and as a result of family related matters (31.84%). Other factors related to RHT were the first-time consultation at A&E (p < 0.0001, CI 3.238–11.051), being young (p < 0.0001, CI: 0.1071–0.2451), having co-morbidities (p = 0.0072, CI: 0.4222-0.8647) and a long stay in the wards (p=0.0003, CI 1.382–3.275).

Conclusion

RHT was more prevalent among males, the young, single and unemployed patients. More RHTs occurred towards the end of the day, at A&E, among those who had long hospital stay, those with family related matters and those with co-morbidities. These identified factors should guide prioritisation in intervention strategies aimed at curbing RHT at Odi District Hospital