Characterization of absconding and attempts to abscond in a Colombian general hospital
DOI:
https://doi.org/10.15649/cuidarte.4548Keywords:
Escape Reaction, Runaway Behavior, Patient Dropouts, HospitalizationAbstract
Highlights
- Patient absconding is a problem for both specialized psychiatric institutions and general care institutions.
- The prevalence of absconding observed was much lower than that reported in other countries, despite patients sharing similar characteristics.
- Absconding and attempts to abscond, as well as the motivations behind these events, vary depending on the regional context.
- Knowing the epidemiological profile of absconding can play an important role in its prevention.
Introduction: Patient absconding in healthcare institutions has been associated with negative outcomes for both patients and the institutions themselves. Despite this, few studies have evaluated the frequency and characteristics of these events in Latin America, especially in general healthcare hospitals that do not specialize in psychiatric care. Objective: To describe the sociodemographic and clinical characteristics, as well as the event characteristics, among patients who absconded or attempted to abscond from a tertiary general hospital in Medellín, Colombia, between 2015 and 2023. Materials and Methods: Quantitative, descriptive cross-sectional study using secondary sources, where information was collected from the medical records of patients who absconded or attempted to abscond at the Hospital Alma Mater de Antioquia. A descriptive statistical analysis of the data was performed. Results: A total of 141 events were recorded during the evaluated period (135 absconds and 6 attempts to abscond). The period prevalence of absconding was 5.5 per 10,000 admissions, and most patients were young, single males, with a high frequency of substance use. Most events took place in the emergency department during the daytime. Discussion: Studying the epidemiological profile of absconding patients and their motivations could facilitate prevention and intervention. Conclusion: A lower absconding rate was found compared to reports from other countries. However, the characteristics of the patients were similar, with a predominance of young, single male patients with psychiatric history.
How to cite this article: Prada Nicolas J, Castrillón-Martínez Esteban, Perez-Gutierrez Ana María, Zapata-Ospina Juan Pablo. Characterization of absconding and attempts to abscond in a Colombian general hospital. Revista Cuidarte. 2025;16(3):e4548. https://doi.org/10.15649/cuidarte.4548
References
Muir-Cochrane E, Mosel KA. Absconding: A review of the literature 1996–2008. Int J Ment Health Nurs. 2008;17(5):370–378. https://doi.org/10.1111/j.1447-0349.2008.00562.x
Yugero Torres O, Pérez Pérez RM. El alta voluntaria y la fuga en los servicios de urgencias: un reto con implicaciones éticas y médico-legales. Emergencias. 2018;30:433–436. https://revistaemergencias.org/numeros-anteriores/volumen-30/numero-6/el-alta-voluntaria-y-la-fuga-en-los-servicios-de-urgencias-un-reto-con-implicaciones-eticas-y-medico-legales/
Hospital Alma Máter. Procedimientos de vigilancia y seguridad física Hospital Alma Máter de Antioquia. Medellín: Hospital Alma Máter de Antioquia; 2024. Consulta: Julio 17, 2024. Disponible en: https://calipsuvisor.ghips.co//FileViewer/VerArchivoPdfJs?fileName=PC-LG-0794%20%20%20PROCEDIMIENTO%20VIGILANCIA%20Y%20SEGURIDAD%20FISICA%20V13.pdf
Hospital Metropolitano de Santiago. Protocolo de acción frente a fuga de pacientes. Santiago de Chile: Hospital Metropolitano de Santiago; 2010. Consulta: Julio 17, 2024. Disponible en: https://sb86eb09335ad47f5.jimcontent.com/download/version/1325778618/module/3697993752/name/Hospital%20Santiago%20de%20Chile%202010%20-Protocolo%20Fuga-.pdf
Olagunju AT, Bouskill SL, Olagunju TO, Prat SS, Mamak M, Chaimowitz GA. Absconsion in forensic psychiatric services: a systematic review of literature. CNS Spectr. 2022;27(1):46–57. https://doi.org/10.1017/S1092852920001881
Anisi S, Zarei E, Kariman H, Kazemi MK, Chehrazi M. Patient Absconding and Its Predictors: A 5-Year Retrospective Analysis in a General Teaching Hospital in Tehran, Iran. Shiraz E-Med J. 2017;18(12):e14532. https://doi.org/10.5812/semj.14532
Bowers L, Banda T, Nijman H. Suicide inside: a systematic review of inpatient suicides. J Nerv Ment Dis. 2010;198(5):315–328. https://doi.org/10.1097/nmd.0b013e3181da47e2
Valdivieso FS, Olivos P, Concha F, et al. Estudio descriptivo de los episodios de fuga en el Hospital Psiquiatrico de Santiago. Rev Psiquiatría. 1989;6(4):281–295. https://schilesaludmental.cl/web/wp-content/uploads/2022/10/89-4-005-Estudio-descriptivo-de-los-episodios-de-fuga-en-el-Hospital-Psiquia%CC%81trico-de-Santiago..pdf
Iglesis Honorato I, Alvarado Alvarez N, Wosiack Menin A, Silva Figueroa M, Escobar Montoya A, Bravo Lazaneo E. Frecuencia de fugas de pacientes en el servicio de urgencia en el Hospital Comunitario de Til Til entre agosto 2016 y agosto 2017. V Congreso de Estudiantes de Medicina de Maule; 2017 Nov 9-11; Talca, Chile. Consulta: Julio 17, 2024. Disponible en: https://portal.ucm.cl/content/uploads/2017/12/Resumen_V_CEMM_2017.pdf
Molnar G, Pinchoff DM. Factors in patient elopements from an urban state hospital and strategies for prevention. Hosp Community Psychiatry. 1993;44(8):791–792. https://doi.org/10.1176/ps.44.8.791
RStudio Team. RStudio: Integrated Development for R. [Internet] 2015 [Cited 2024 Sept 8]. Available from: http://www.rstudio.com/
Prada Aceros NJ, Castrillon-Martinez E, Perez-Gutierrez AM, Zapata-Ospina JP. Características sociodemográficas y clínicas de pacientes que presentaron fuga o intento de fuga en el HAMA. 2024. Mendeley Data: Versión 1. https://doi.org/10.17632/jhw2pzxc7h.1
Khammarnia M, Kassani A, Amiresmaili MR, Sadeghi A, Karimi Jaberi Z, Kavosi Z. Study of patients absconding behavior in a general hospital at southern region of Iran. Int J Health Policy Manag. 2015;4(3):137–141. https://doi.org/10.15171/ijhpm.2014.110
Cheng ST, Chung CH, Leung YH, Lai KK. Patient absconding behaviour in a public general hospital: retrospective study. Hong Kong Med J. 2002;8(2):87–91. https://www.hkmj.org/abstracts/v8n2/87.htm
Moradpour M, Amiresmaili M, Nekoei-Moghadam M, Dehesh Tania. The reasons why patients abscond from public hospitals in southeastern Iran: a qualitative study. Arch Public Health. 2021;79(1):106. https://doi.org/10.1186/s13690-021-00634-z
Muir-Cochrane E, Muller A, Oster C. Absconding: A qualitative perspective of patients leaving inpatient psychiatric care. Int J Ment Health Nurs. 2021;30(5):1127–1135. https://doi.org/10.1111/inm.12863
Yahyavi ST, Faraji S. Absconding from a Psychiatric Hospital in a Developing Country, Related Factors, and the Consequences. Med J Islam Repub Iran. 2023;37(1):865-869. https://doi.org/10.47176/mjiri.37.110
Atienza Martinez A, Font Pujol J, Buxó Pujolràs M, Turró Garriga O. Conociendo al paciente con riesgo de fuga. Rev Enferm Salud Ment. 2017;5–14. https://doi.org/10.5538/2385-703X.2017.8.5
Gerace A, Oster C, Mosel K, O’Kane D, Ash D, Muir-Cochrane E. Five-year review of absconding in three acute psychiatric inpatient wards in Australia. Int J Ment Health Nurs. 2015;24(1):28–37. https://doi.org/10.1111/inm.12100
Martin K, McGeown M, Whitehouse M, Stanyon W. Who’s going to leave? An examination of absconding events by forensic inpatients in a psychiatric hospital. J Forensic Psychiatry Psychol. 2018;29(5):810–823. https://doi.org/10.1080/14789949.2018.1467948
Handel DA, Fu R, Daya M, York J, Larson E, John McConnell K. The Use of Scripting at Triage and Its Impact on Elopements. Acad Emerg Med. 2010;17(5):495–500. https://doi.org/10.1111/j.1553-2712.2010.00721.x
Bowers L. Safewards: a new model of conflict and containment on psychiatric wards. J Psychiatr Ment Health Nurs. 2014;21(6):499–508. https://doi.org/10.1111/jpm.12129
Fletcher J, Reece J, Kinner SA, Brophy L, Hamilton B. Safewards Training in Victoria, Australia: A Descriptive Analysis of Two Training Methods and Subsequent Implementation. J Psychosoc Nurs Ment Health Serv. 2020;58(12):32–42. https://doi.org/10.3928/02793695-20201013-08
Fletcher J, Hamilton B, Kinner S, Sutherland G, King K, Tellez JJ, et al. Working towards least restrictive environments in acute mental health wards in the context of locked door policy and practice. Int J Ment Health Nurs. 2019;28(2):538–550. https://doi.org/10.1111/inm.12559
McKenna B, Furness T, Dhital D, Ennis G, Houghton J, Lupson C, et al. Recovery-Oriented Care in Acute Inpatient Mental Health Settings: An Exploratory Study. Issues Ment Health Nurs. 2014;35(7):526–532. https://doi.org/10.3109/01612840.2014.890684
Marlett JE, Vacovsky BA, Krug EA, Ha‐Johnson TM, Hill SAF. Elopement: Evidence‐based mitigation and management. Worldviews Evid Based Nurs. 2023;20(6):634–641. https://doi.org/10.1111/wvn.12683
Booth BD, Michel SF, Baglole JS, Healey LV, Robertson HV. Validation of the Booth Evaluation of Absconding Tool for Assessment of Absconding Risk. J Am Acad Psychiatry Law. 2021;49(3):338–349. https://europepmc.org/article/med/34001671
Brumbles D, Meister A. Psychiatric elopement: using evidence to examine causative factors and preventative measures. Arch Psychiatr Nurs. 2013;27(1):3–9. https://doi.org/10.1016/J.APNU.2012.07.002
Wilkie T, Penney SR, Fernane S, Simpson AIF. Characteristics and motivations of absconders from forensic mental health services: a case-control study. BMC Psychiatry. 2014;14(1):91. https://doi.org/10.1186/1471-244X-14-91
Tommasini NR, Iennaco JD. A Model Program to Manage Behavioral Emergencies and Support Nurses in the Medical Setting. Nurs Adm Q. 2022;46(1):37–44. https://doi.org/10.1097/NAQ.0000000000000501
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