COVID-19 outbreak impact on discharge against medical advice from the ED: A retrospective study

Aydın, Hakan; Doğan, Halil

doi:10.1016/j.ajem.2022.04.008

Cited by 12 publications

(5 citation statements)

References 26 publications

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“…This shows that the pandemic has impacted patients not infected with COVID-19, which should not be overlooked. According to Aydin and Doğan [ 24 ] and Demir et al . [ 25 ], it is reasonable to presume that sick people face an “avoidance-avoidance conflict” as a result of the anxiety caused by the danger of COVID-19 transmission when they are hospitalized.…”

Section: Discussionmentioning

confidence: 99%

“…[ 25 ], this could be because people with comorbidities believe they require greater medical attention. The more significant percentage of patients with a higher burden of respiratory infection in LAMA cases could be because these patients choose not to be in the hospital, where the risk of COVID-19 transmission is considerable [ 24 ]. This result may help inform the essential safeguards for all patients, particularly very ill patients, to feel safe at the hospital and receive proper treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Demir et al . [ 24 ] reported that age and gender were not influencing factors in the decision to leave the hospital. However, the finding opposes several studies by other scholars [ 8 , 14 , 16 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Incidence of patients leaving against medical advice in government-subsidized hospitals: a descriptive retrospective study

Pasay-an¹,

Mostoles²,

Villareal³

et al. 2022

Pan Afr Med J

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Introduction this study aimed to determine the prevalence of leaving against medical advice (LAMA) in the local context and the associated predictors to help develop effective strategies to reduce its likelihood. Methods this study employed a retrospective approach using medical records of the 16233 patients between 2016 and 2020 at various government-subsidized hospitals in the Hail region of Saudi Arabia. Results the prevalence of LAMA was the highest in 2019 (91.9%) and 2017 (21.45%) among insured and non-insured patients, respectively. Furthermore, it was the highest among patients aged 20-25 years and the lowest among patients aged 46 years and above. The incidence of LAMA was the highest (15.48% for males and 29.53% for females) in 2016. In 2016-2019, the most common reason for LAMA was “wanted medication only,” while in 2020, the “fear of infection with COVID-19” was the main reason. High blood sugar was the most common diagnosis among the patients under consideration during the study period. Significant association was found between LAMA and patient's insurance status (t = 4.3123; p < 0.002); however, no association was found between LAMA and age (t = -0.8748; p > 0.658) and gender of patients (t = 1.9008; p > 0.302). Conclusion strategies such as developing a suitable environment for patients and taking due care of their needs, providing individual consulting services, enhancing staff relations, and providing support to patients in need are vital. The likelihood of LAMA can be minimized by informing hospitalized patients and their relatives about the adverse effects of LAMA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Incidence of patients leaving against medical advice in government-subsidized hospitals: a descriptive retrospective study

Pasay-an¹,

Mostoles²,

Villareal³

et al. 2022

Pan Afr Med J

View full text Add to dashboard Cite

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“…The COVID-19 pandemic has profoundly affected the entire healthcare system (16,17). This includes ED visits and patients' behavior (17)(18)(19). New variants of Sars-Cov-2 and waves in the pandemic remain a cause for concern.…”

Section: Discussionmentioning

confidence: 99%

Koronavirüs hastalığı 2019 hastalarında varyantların ve aşıların prognoza etkisi: retrospektif gözlemsel çalışma

Aydın

Berikol

Koçak

et al. 2022

Anadolu Kliniği Tıp Bilimleri Dergisi

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Aim: The effect of novel coronavirus disease 2019 (COVID-19) vaccines on variants of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is unclear. In this study, we aimed to investigate the prognostic effect of variants and vaccines in hospitalized COVID-19 patients. Materials and Methods: This retrospective study was conducted in 588 hospitalized patients with COVID-19 between May 1st, 2021 and August 31st, 2021. The patients were divided into groups according to variant analysis and demographic characteristics, laboratory data, vaccination status and in-hospital mortality rates were compared. Results: Variants (Alpha [B.1.1.7], Beta [B.1.351], Delta [B.1.617.2]) were detected in 46.3% of the patients. The intensive care unit (ICU) admission rate was 46.8% and the in-hospital mortality rate was 33.3%. There was no statistically significant difference between the patients with variant detection and those without variant detection in terms of ICU admission and in-hospital mortality. The rate of unvaccinated patients was 63.6%. The in-hospital mortality rate was similar in those vaccinated with two doses of CoronaVaC (37.1%) to that in the unvaccinated (32.9%), but higher than in those vaccinated with two doses of BNT162B2 (16.7%). Conclusion: There was no increase in the mortality rates in hospitalized patients with variants compared to those without. The mortality rate in those vaccinated with two doses of CoronaVaC was similar to that in those not vaccinated.

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“…The prevalence rate ranges from 0.07 to 20% in the ED. During the pandemic period, DAMA cases increased ICMEDH by 24.5% in the ED compared to the previous period (2). The patient's condition is relevant to several problems, including an increased risk for adverse health side effects, re-admission to the ED, and hospitalization (3,4).…”

Section: Introductionmentioning

confidence: 99%

Association Between Door-to-Doctor Time and Discharge Against Medical Advice in Patients with COVID-19 from the ED

Herlianita

Pratiwi

Nuraini

et al. 2023

Kme

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The cause of Discharge Against Medical Advice (DAMA) is a long response time/doorto- doctor time, which is not according to the recommendation of 5 minutes. This study aimed to determine the association between Door to Doctor Time and DAMA incidence in patients with COVID-19 from the ED. The research design used is a cross-sectional study. This study used a purposive sampling technique (n = 414) in patients with COVID-19 symptoms who came or were referred to the ED in December 2020-April 2021. The data analysis used the Spearman correlation test. The results of this study indicate that most response times with response time indicators arrive until the initial action is not according to recommendations, namely 75 patients (18.1%). In contrast, the response time (response time for initial treatment to supporting laboratory examinations) is dominated by the same response time as many as 54 patients (13.0%). The results of the Spearman correlation show a positive correlation between the two waiting times / Door to Doctor time with an indicator (response time to achieve initial action) with the incidence of DAMA in COVID-19 patients. The correlation value is 0.000 (sig < 0.05), which is 0.436, and (the response to initial handling time until laboratory examination) has a correlation value of 0.413 with the same relationship, namely positive and unidirectional. At the same time, the strength of associations was moderate. The door to Doctor Time / Response time with indicators (response time from arrival to initial action and response time to initial treatment to supporting laboratory tests) is associated with the incidence of DAMA in patients with Covid-19 in the ED. The longer the response time will affect the incidence of DAMA in COVID-19 patients. Keywords: discharge against medical advice, door to the doctor time, COVID-19, ED

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COVID-19 outbreak impact on discharge against medical advice from the ED: A retrospective study

Cited by 12 publications

References 26 publications

Incidence of patients leaving against medical advice in government-subsidized hospitals: a descriptive retrospective study

Incidence of patients leaving against medical advice in government-subsidized hospitals: a descriptive retrospective study

Koronavirüs hastalığı 2019 hastalarında varyantların ve aşıların prognoza etkisi: retrospektif gözlemsel çalışma

Association Between Door-to-Doctor Time and Discharge Against Medical Advice in Patients with COVID-19 from the ED

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