Discharge against medical advice at a general hospital in Catalonia

Duñó, Rosó; Pousa, Esther; Sans, Jordi; Tolosa, Carles; Ruiz, A. Barona

doi:10.1016/s0163-8343(02)00253-0

Cited by 40 publications

(35 citation statements)

References 13 publications

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“…This rate was higher than overall DAMA prevalence, estimated at 1% of all patients in both Canada and the US. This is a lower rate than that found in TBI acute care settings (2.84%) [7] and stroke rehabilitation settings (3.3%) [3], but higher than the rates found in Duñ ó et al's [4] study (0.93%). This study also found that cause of injury (intentional injury) and motor FIM were associated with DAMA in rehabilitation settings.…”

Section: Discussioncontrasting

confidence: 58%

“…DAMA has been reported for many diagnoses across many medical departments and many emergency and psychiatric hospitals. Duñ ó et al [4] found that 0.93% of patients in rehabilitation discharged against medical advice, which was the highest DAMA rate across medical fields, followed by internal medicine (0.44%) and obstetrics-gynecology (0.32%). In spite of these studies, research on DAMA is scarce and, of studies that exist, information on DAMA specifically in rehabilitation settings is limited.…”

Section: Introductionmentioning

confidence: 99%

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An examination of discharge against medical advice from brain injury inpatient rehabilitation

Kim

Colantonio

2013

Brain Injury

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Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

An examination of discharge against medical advice from brain injury inpatient rehabilitation

Kim

Colantonio

2013

Brain Injury

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“…Some studies on discharge against medical advice (AMA) in general hospitals report prevalence between 0.7–7% with 11–42% of this population identified as psychiatric patients. A total of 142 patients left the hospital AMA during the two-year period (1998–1999), the global discharge number in the same period being 41,648 (17). …”

Section: Introductionmentioning

confidence: 99%

“…In some sources, the reasons such as feeling well enough, dissatisfaction with treatment, lack enough staff to treat a patient’s condition, Personal and family problems, marginalization living of patients, patients without insurance, psychiatric and addiction problems, general dissatisfaction with the Hospital referred the causes of Discharge with Discharge against medical advice (AMA) (1, 8, 17-21). …”

Section: Introductionmentioning

confidence: 99%

Studying the Rate and Causes of Discharge Against Medical Advice in Hospitals Affiliated to Mazandaran University of Medical Sciences

et al. 2014

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Introduction:Discharge against medical advice from the hospital is an important issue from point of view of treatment management, health costs as well as the side effects of treatment stop on patients and their accompanying. Therefore, health managers and planners should consider the predisposing factors that change patient’s mind in this regard. Since, there has been no study to carefully assess the rate and causes of self-discharge in this province, so this study is aimed to fill this gap.Methods and Materials:This descriptive and cross-sectional study was carried out in 6 months period, from 23 July 2010 till 20 January 2011 in all public hospitals of Mazandaran province. A form was set out for data collection and those patients willing to self-discharge were asked to participate in the study. Patients’ demographic information was filled using their medical record and by the help of department personnel. Furthermore, the form was completed by parents for patients over 18 year-old or by the help of first-rank relative for those having psychiatric disorders or anybody who wasn’t able to complete the form. In order to identify the causes of self-discharge, 18 variables were determined which were categorized in three general items and five main groups. Data were entered into the SPSS15 and were analyzed using descriptive statistics indices.Results:According to the results, 94441 were discharged from the university hospitals which 7967 patients (8.4 %) of them were self-discharged during the 6 month study period. Regarding admission type, 269 (3.3 %), (54.5 %) were admitted into the hospital by pre-determined appointment and as usual patients, respectively, and the rest were admitted by emergency department. Also, 31.4%(2504) were hospitalized in surgery ward, 63% (5026) in medical ward, 4.6% (374) in intensive care unit (ICU) and the rest were hospitalized in the psychiatric ward. The most important reasons for self-discharge were related to: 1-factors affecting patient illness (54.3%), 2-environmental issues as well as patients’ accompanying (37.6%) and 3-managerial and medical reasons(7.9%), respectively.Conclusion:Our study showed the same results for Discharge against medical advice rate as the others. From the view point of treatment management, its causes should be considered and practices should be done to improve the conditions. Meanwhile, the current self-discharge form doesn’t reflect the causes of the problem and it should be revised.

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“…The mean age of patients of 50.8 ± 18.3 years is higher than that found in other studies. [12,20] This is likely due to the fact that these other studies included the pediatric age group while ours concentrated mainly on adults. Another plausible reason is that the largest age sub-group among our sample was that of patients above 60 years.…”

Section: Discussionmentioning

confidence: 88%

Discharge against medical advice: Experience from a rural Nigerian hospital

et al. 2013

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A B S T R A C TIntroduction: Discharge against medical advice (DAMA) is a worldwide problem with negative health and socioeconomic effects. Factors that have been implicated as causes or contributing to DAMA include fi nancial constraints, lack of health insurance, deteriorating clinical condition of the patient, and problematic doctorpatient relationships. Aims: To determine the incidence and profi les of DAMA on the medical wards, so as to allows for evidencebased interventions to reduce this problem to a minimum. Materials and Methods:This was a case-control study carried out on the medical wards of Federal Medical Center, Ido-Ekiti, South-West Nigeria. The medical records of all patients admitted to the male and female medical wards between January 2008 and April 2011 were reviewed. After being identifi ed through the admission/discharge log, patients who were DAMA and a similar number of patients with regular discharge had their case notes retrieved. Information extracted included bio-data, diagnosis, duration of hospital stay, and reason for discharge. Results: One hundred and thirty-eight patients representing 7.2% were DAMA during the study period. Ninety fi ve cases had complete medical records, and full analysis was carried out on these and 94 other cases with regular discharge as control. The mean age of the DAMA cases was 50.8 ± 18.3 years, with 58 (61.1%) of these patients being male; while the mean age of the control group was 54.1 ± 16.5, of which 54 (57.4%) were male. The mean duration of admission for patients with DAMA was 10.4 ± 9.2 days as against 11.9 ± 10 in the control group, a difference that is not statistically signifi cant. The associations between type of discharge, sex, and duration of admission are shown through odds ratios of 0.883 and 0.833 respectively. Financial problems (48%), lack of clinical improvement (28.8%) and leaving to seek alternative/complimentary medical care (23.1%) were the factors found to be responsible for DAMA in the study. Conclusion: The incidence of discharge against medicine is high in this study. There is a need for all stakeholders to evaluate factors responsible for DAMA, with the aim of reducing this trend.

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Discharge against medical advice at a general hospital in Catalonia

Cited by 40 publications

References 13 publications

An examination of discharge against medical advice from brain injury inpatient rehabilitation

An examination of discharge against medical advice from brain injury inpatient rehabilitation

Studying the Rate and Causes of Discharge Against Medical Advice in Hospitals Affiliated to Mazandaran University of Medical Sciences

Discharge against medical advice: Experience from a rural Nigerian hospital

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