[Investigation of self-discharged patients of pulmonary tuberculosis]

This study investigates 27 cases in which the patients left hospital care without permission for personal reasons. These patients were classified as "self-discharged patients". Each of the patients had been diagnosed as having pulmonary tuberculosis, and were receiving treatment at the National Chiba Higashi Hospital during the period from January 1988 to July 1991. Disease was in an advanced stage in each of the patients when admitted: all sputum examinations were positive and chest roentgenograms revealed cavities in 26 patients. In addition to pulmonary tuberculosis, the patients were also diagnosed has having a variety of other medical complications such as diabetes mellitus, gastric ulcers and liver disease. Many of them were unemployed or were day labors. Reasons attributed to patients self-discharge from the hospital included repetition of alcohol drinking and unauthorized outings. At the time patients chose to leave hospitalization 11 cases checked positive for sputum examinations, and 16 cases never returned to complete therapy. Many of them were rated as high risk patients for pulmonary tuberculosis because they had no immediate family, did not own a residence or have regular employment thus economic and psychological conditions were very low. There is a high possibility that these individuals will suffer pulmonary tuberculosis relapse and become infectious bacteria carriers. It is important that such patients be hospitalized long enough to receive adequate treatment to prevent then from becoming infectious carriers and spreading disease.