Global Problem of Hospital Detention Practices

Area of Science:

• Public Health
• Human Rights Law
• Medical Ethics

Background:

• Hospital detention practices (HDP), defined as refusing patient or body release due to unpaid bills, lack official definitions and consistent terminology.
• Previous reports of HDP are scarce, leaving the global scale of the problem unknown.
• The Universal Declaration of Human Rights is signed by most countries, yet HDP may violate these rights.

Purpose of the Study:

• To identify global evidence of hospital detention practices (HDP).
• To analyze the characteristics of HDP reports and compare countries with and without reported incidents.
• To explore factors associated with countries reporting HDP.

Main Methods:

• A systematic search of PubMed and Google for English, Spanish, and French publications up to January 2019.
• Analysis of 195 countries to identify HDP reports.
• Statistical comparison of countries with and without HDP reports based on population, corruption, healthcare expenditure, universal health coverage, and press freedom.

Main Results:

• HDP reports were found in 46 countries (24%) across all continents, with most reports from newspapers.
• Detentions often involved living adults and children, with 52% held for at least one month.
• Countries reporting HDP showed larger populations, higher corruption, increased out-of-pocket expenditure, lower universal health coverage, and poorer press freedom.

Conclusions:

• Hospital detention practices are more prevalent globally than currently recognized.
• HDP are associated with socioeconomic and governance factors, including corruption and limited healthcare access.
• Urgent stakeholder intervention is necessary to eradicate hospital detention practices.