2 research outputs found
Reasons for Discharge against Medical Advice: A Case Study of Emergency Departments in Iran
Background
: Incomplete hospitalization is the cause of disease relapse, readmission, and increase in
medical costs. Discharge Against Medical Advice (DAMA) in emergency department (ED) is critical
for hospitals. This paper aims to explore the underlying reasons behind DAMA in ED of four teaching
hospitals in Kerman, Iran.
Methods
: This was a cross-sectional study in which the samples were drawn from the patients who chose
to leave against medical advice from the ED of teaching hospitals in Kerman from February to March
2011. The sampling was based on census. Data were gathered by a self-constructed questionnaire. The
reasons for DAMA were divided into three parts: reasons related to patient, medical staff, and hospital
environment. The questionnaire was filled out by a face-to-face interview with patient or a reliable
companion.
Results
: There were 121 cases (5.6%) of DAMA out of the total admissions. The main reason of AMA
discharges was related to patient factors in 43.9% of cases, while two other factors (i.e., hospital environment
and medical staff ) constituded 41.2% and 35.2% of cases, respectively. The majority of patients 65.9% (80
cases) were either uninformed or less informed of the entailing side effects and outcomes of their decision
to DAMA.
Conclusion
: In comparison to studies conducted in other countries, the rate of DAMA is markedly
higher in Iran. The results revealed that patients awareness of the consequences of their decisions is
evidently inadequate. The study suggests a number of recommendations. These include, increasing patient
awareness of the potential side effects of DAMA and creating the necessary culture for this, improving
hospital facilities, and a more careful supervision of medical staff performance
Reasons for Discharge against Medical Advice: A Case Study of Emergency Departments in Iran
Background: Incomplete hospitalization is the cause of disease relapse, readmission, and increase in
medical costs. Discharge Against Medical Advice (DAMA) in emergency department (ED) is critical
for hospitals. This paper aims to explore the underlying reasons behind DAMA in ED of four teaching
hospitals in Kerman, Iran.
Methods: This was a cross-sectional study in which the samples were drawn from the patients who chose
to leave against medical advice from the ED of teaching hospitals in Kerman from February to March
2011. The sampling was based on census. Data were gathered by a self-constructed questionnaire. The
reasons for DAMA were divided into three parts: reasons related to patient, medical staff, and hospital
environment. The questionnaire was filled out by a face-to-face interview with patient or a reliable
companion.
Results: There were 121 cases (5.6%) of DAMA out of the total admissions. The main reason of AMA
discharges was related to patient factors in 43.9% of cases, while two other factors (i.e., hospital environment
and medical staff) constituded 41.2% and 35.2% of cases, respectively. The majority of patients 65.9% (80
cases) were either uninformed or less informed of the entailing side effects and outcomes of their decision
to DAMA.
Conclusion: In comparison to studies conducted in other countries, the rate of DAMA is markedly
higher in Iran. The results revealed that patients awareness of the consequences of their decisions is
evidently inadequate. The study suggests a number of recommendations. These include, increasing patient
awareness of the potential side effects of DAMA and creating the necessary culture for this, improving
hospital facilities, and a more careful supervision of medical staff performance