Prevalence of and Reasons for Patients Leaving Against Medical Advice from Paediatric Wards in Oman

Al-Ghafri, Mohamed; Al-Bulushi, Abdullah; Al-Qasmi, Ahmed

doi:10.18295/squmj.2016.16.01.013

Cited by 9 publications

(5 citation statements)

References 14 publications

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“…16 In a study by Ghafri et al, the prevalence of LAMA was 8.49% having no seasonal variations or any other significant difference between general and subspecialty wards. 17 A study by Schrijver et al, the four diseases that fulfilled our definition of seasonality: respiratory tract infections (peak in January), gastroenteritis (peak in February-March), functional complaints (peak in March and November), and asthma (peak in March and October). Together, these four categories comprised 21.2% of all newly referred patients.…”

Section: Discussionmentioning

confidence: 99%

Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan

Seema¹,

Khan²,

Jiskani³

et al. 2019

Int J Res Med Sci

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Background: In pediatrics, the season is one of the elements contributing to the etiological factors of community based diseases. Awareness of this variation can help the physicians for prevention and counseling of the patients. A cross-sectional observational study was designed with non-probability convenient sampling technique to determine the frequency of patients admitted to the paediatric ward of the hospital in a whole calendar year and to ascertain which disease presentation is most common. Methods: Study conducted at paediatric ward of Al-Tibri Medical College and Hospital Karachi, Pakistan having patients admitted during May 2018 to April 2019. After ethical approval and informed consent from their parents/ guardian, a total of 734 paediatric patients that were admitted from paediatric OPD/ emergency were selected for the study. Paediatric patients that were referred, in emergency/ ICU and surgical paediatric patients were excluded from the study. Chi-square test was applied to evaluate the statistical variation among the patients.Results: From the 734 patients, 357 (48.6%) patients were of acute gastroenteritis, 104 (14.2%) of respiratory illness, 86 (11.7%) of viral fever, 67 (9.1%) of urinary tract infection, 36 (4.9%) of neurological illness, 29 (4.0%) of protein calorie malnutrition, 25 (3.4%) of enteric fever, 20 (2.7%) of haematological illness and 10 (1.4%) patients were admitted due to sepsis.Conclusion: Our study concluded that majority of the patients admitted were of acute gastroenteritis / admitted due to gastric issues, therefore further studies in the vicinity would help to better understand the issues and help plan a strategy to combat the diseases.

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Section: Discussionmentioning

confidence: 99%

Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan

Seema¹,

Khan²,

Jiskani³

et al. 2019

Int J Res Med Sci

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“…7 But the LAMA rate remains high in neonates 35.8 % as reported by Duru, and infants 40.4% by Gafri respectively. 8,9 Kumar R. Int J Contemp Pediatr. 2019 Jan;6(1):176-180…”

Section: Discussionmentioning

confidence: 99%

Leave against medical advice from SNCU of a teaching hospital in Garhwal, Uttarakhand, India

Kumar

2018

Int J Contemp Pediatr

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Background: Patients who leave against medical advice (LAMA) is a universal problem. Neonates being unable to decide for their own, are dependent on parents for all decisions for their treatment. LAMA is a sensitive issue in neonatology practice with ethical and medico legal ramifications. This study was done to evaluate the factors associated with the decision of LAMA by care givers in our special newborn care unit (SNCU).Methods: This is a retrospective hospital based observational study and was conducted in SNCU of HNB Base Teaching Hospital, Srinagar, Garhwal. Data pertaining to LAMA between 1st August 2017 and 31st July 2018 was retrieved. Information obtained included place of birth, gestational age, weight, diagnoses, duration of hospital stay and reasons for LAMA. Data were entered into a Microsoft Excel Spread Sheet and analyzed using software. Graph Pad Prism v 7.04. Chi-Square test was used to test for significant difference among various groups.Results: Out of 689 neonates admitted in SNCU during the study period, 167 (24.24%) took LAMA. Male to female ratio of 1:1.1. 102 (61%) were inborn and 65 (39%) were out born. Term babies constituted 62.87%. 78.44% neonates were discharged within 7 days of admission. 58 (34.73%) neonates had sepsis and 30 (17.96%) had birth asphyxia. The commonest reason in 25.15% for taking LAMA was to take the neonate to better equipped facility followed by false perception that the baby is well enough to be discharged.Conclusions: Multiple factors contribute for getting a neonate discharged against medical advice. Improvement of infrastructure, training of health care staff for proper counselling, sensitivity and empathy towards neonate and the care givers can decrease the rate of LAMA.

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“…The mean length of stay observed in the study is 4.8 days longer than, compared to previous studies done in oman (3.1 days). 7 Among the DAMA patients' newborns were predominant, accounted to 61.6% of DAMA and neonatal condition which are commonly associated with DAMA observed in this study were neonatal jaundice, sepsis, prematurity. Followed by newborns were children between 1 to 3 years of age and infants (1month -1year) accounting to 13% and 11.1 % respectively.…”

Section: Discussionmentioning

confidence: 47%

“…When compared to prevalence of 3.1% in a study done in Nigeria and 1.6% in a study discharge against medical advice among children in Oman. 4,7 The male to female ratio among DAMA patients is 1.2:1.…”

Section: Discussionmentioning

confidence: 99%

Study on demographic factors of discharge against medical advice in pediatric population

Vidya

Shetty

2020

Int J Contemp Pediatr

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Background: Discharge against medical advice (DAMA) is of serious concern among the pediatrics population. Parent(s)/guardians understanding about the disease and various other factors play role in their decision of DAMA. The aim of this study is to know the prevalence of DAMA in a tertiary care center and to observe the gender stratification in DAMA.Methods: A retrospective survey of medical records of children discharge against medical advice during the period January 2017 to January 2019. Demographic data, length of hospital stay, clinical diagnosis and procedure refused was collected.Results: Total 12977 were discharged during the study period of which, 387 children were DAMA, prevalence of DAMA was 2.9%, male to female ratio among DAMA patients is 1.2:1. The mean length of stay was 4.8 days. Among the DAMA patients’ newborns were predominant (61.6 %), p value = 0.0001, highly significant. No significant difference with respect to age and gender (p value = 0.535). Out of 370 DAMA patients, 211 patients who required further investigations and procedure was refused by parents/guardians (p value = 0.0001) highly significant. Phototherapy refusal was most common among newborn (59.7%), followed by neuroimaging and lumbar puncture in children (10.9%).Conclusions: DAMA was observed more among the newborns compared to infants, toddlers and children. Among newborns, phototherapy refusal was most common. In infants and children neuroimaging and lumbar puncture was the most commonly refused procedure. There was no gender bias.

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Prevalence of and Reasons for Patients Leaving Against Medical Advice from Paediatric Wards in Oman

Cited by 9 publications

References 14 publications

Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan

Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan

Leave against medical advice from SNCU of a teaching hospital in Garhwal, Uttarakhand, India

Study on demographic factors of discharge against medical advice in pediatric population

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