Incidence and reasons for leave against medical advice among orthopedic and trauma patients at the university college hospital Ibadan

Background: Leave against medical advice (LAMA) of hospitalized patients is an adverse clinical event in which a patient chooses to leave the hospital before it is medically advisable to do so and it negatively affects the treatment outcome. Because of this, the study was designed to determine the incidence of and indications for LAMA among orthopedic patients who presented at the accident and emergency department of the university college hospital, Ibadan.Methods: This was a prospective hospital-based study determining the incidence of LAMA among orthopedic patients who presented at the accident and emergency department of the university college hospital, Ibadan between September 2019 and March 2020.Results: A total of 289 patients with orthopedic conditions presented within the study period and about 12.46% of these LAMA. The male to female ratio observed in this study is 2:1. The age range was between 8 and 93 years. Trauma from motorbike and motor vehicle accidents accounted for over 80% of the etiology. The most important factor influencing LAMA is financial constraints (63.9%) and LAMA was signed mostly by the patients (25%).Conclusions: LAMA among orthopedic patients in Ibadan is mostly due to financial reasons, therefore, factors that will reduce the cost of management such as the accessibility to health insurance schemes will significantly reduce the incidence of LAMA among orthopedic patients in Nigeria.