scholarly journals Reasons for Discharge against Medical Advice: A Case Study of Emergency Departments in Iran

2013 ◽  
Vol 1 (2) ◽  
pp. 137-142 ◽  
Author(s):  
Kaveh Noohi ◽  
Samaneh Komsari ◽  
Nouzar Nakhaee ◽  
Vahid Yazdi Feyzabadi
Keyword(s):  
Emergency Departments ◽  
Medical Advice ◽  
Against Medical Advice ◽  
Discharge Against Medical Advice

scholarly journals Discharge Against Medical Advice: A Qualitative Case Study

2016 ◽  
Vol 5 (1) ◽  
pp. 31-41
Author(s):  
Tahereh Shafaghat ◽  
Alireza Jabbari ◽  
Zahra Kavosi ◽  
Seyed Mojtaba Hosseini ◽  
Ali Ayoubian ◽  
...  
Keyword(s):  
Qualitative Case Study ◽  
Medical Advice ◽  
Medical Sciences ◽  
Against Medical Advice ◽  
Telephone Interviews ◽  
Hospital Managers ◽  
Number Of Patients ◽  
Discharge Against Medical Advice ◽  
Inadequate Care

Background: The most important criterion for healthcare success is customers’ satisfaction. The number of patients leaving the hospital on their own decision or Against Medical Advice (AMA) can be a sign of their discontent and a problem with considerable importance. In this regard, the present study was designed aiming at evaluating the causes of AMA discharges at a hospital affiliated with Shiraz University of Medical Sciences. Materials and Methods: This is a qualitative study on all patients who were discharged AMA from the studied hospital during 3 months in 2012 (March 21 – June 21). Data were collected through telephone interviews. All interviews were written by the researcher and analyzed using grounded theory with thematic method. Results: The most frequent reasons for discharge AMA were classified into 3 general themes: issues related to hospital status, the staff and the patients. Additionally, the most frequent reasons causing discharge AMA were as follows; 1. Sense of recovery; 2. Failure to register discharge order despite verbal order, 3. Physicians and nurses’ inadequate care (technically); 4. Lack of informing the patients and their relatives as to the patient’s condition properly; 5. Crowded wards; 6. Lack of attention to patients by the staff (emotionally).  Conclusion: It seems that if hospital managers want to reduce discharge AMA, it is better to consider the causes. Based on such causes, effective intervention can be implemented which may differ in terms of resource-consuming. [GMJ. 2016;5(1):31-41]

scholarly journals Why Do Patients Leave against Medical Advice? Reasons, Consequences, Prevention, and Interventions

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 111
Author(s):  
Asseel Albayati ◽  
Steven Douedi ◽  
Abbas Alshami ◽  
Mohammad A. Hossain ◽  
Shuvendu Sen ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Medical Advice ◽  
Preventive Strategies ◽  
Against Medical Advice ◽  
Cause Analysis ◽  
Persistent Problem ◽  
Root Cause ◽  
Discharge Against Medical Advice ◽  
Leaving Against Medical Advice

Background: A patient decides to leave the hospital against medical advice. Is this an erratic eccentric behavior of the patient, or a gap in the quality of care provided by the hospital? With a significant and increasing prevalence of up to 1–2% of all hospital admissions, leaving against medical advice affects both the patient and the healthcare provider. We hereby explore this persistent problem in the healthcare system. We searched Medline and PubMed within the last 10 years, using the keywords “discharge against medical advice,” “DAMA,” “leave against medical advice,” and “AMA.” We retrospectively reviewed 49 articles in our project. Ishikawa fishbone root cause analysis (RCA) was employed to explore reasons for leaving against medical advice (AMA). This report presents the results of the RCA and highlights the consequences of discharge against medical advice (DAMA). In addition, the article explores preventive strategies, as well as interventions to ameliorate leaving AMA.

scholarly journals A nationally representative study on discharge against medical advice among those living with epilepsy

Seizure ◽  
2021 ◽  
Vol 84 ◽  
pp. 84-90
Author(s):  
Parul Agarwal ◽  
Huaqing Xi ◽  
Nathalie Jette ◽  
Jung-yi Lin ◽  
Churl-Su Kwon ◽  
...  
Keyword(s):  
Medical Advice ◽  
Against Medical Advice ◽  
Representative Study ◽  
Discharge Against Medical Advice ◽  
Nationally Representative

scholarly journals Informal psychiatric patients requesting discharge

1994 ◽  
Vol 18 (4) ◽  
pp. 209-211
Author(s):  
Robin McGilp ◽  
Brian Kidd ◽  
Cameron Stark ◽  
Tom Henderson
Keyword(s):  
Substance Abuse ◽  
Psychiatric Patients ◽  
Medical Advice ◽  
Psychotic Illness ◽  
Against Medical Advice ◽  
The Past ◽  
History Of ◽  
Self Harm ◽  
Discharge Against Medical Advice ◽  
Retrospective Investigation

A retrospective investigation of case-notes compared 54 incidents of informal psychiatric in-patients being detained in hospital on an emergency basis with 66 incidents of discharge against medical advice (AMA). The characteristics of the two groups were compared. Detained patients were more likely to have been detained previously, to be suffering from a psychotic illness, and to have threats of violence or self-harm mentioned in their case-notes. AMA patients were more likely to have a history of substance abuse but were no more likely than the detained group to have been discharged AMA in the past. The results suggest that psychiatrists in this hospital are using current legislation on detention appropriately.

Discharge against medical advice at a general hospital in Catalonia

2003 ◽  
Vol 25 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Rosó Duñó ◽  
Esther Pousa ◽  
Jordi Sans ◽  
Carles Tolosa ◽  
Ada Ruiz
Keyword(s):  
General Hospital ◽  
Medical Advice ◽  
Against Medical Advice ◽  
Discharge Against Medical Advice

scholarly journals Rate and causes of discharge against medical advice from a university hospital emergency department in Iran: an ethical perspective

2020 ◽  
Author(s):  
Sanaz Rouhbakhsh Halvaei ◽  
Hojat Sheikh Motahar Vahedi ◽  
Ayat Ahmadi ◽  
Maryam Sadat Mousavi ◽  
Alireza Parsapoor ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical Staff ◽  
Medical Advice ◽  
University Hospital ◽  
P Value ◽  
Emergency Ward ◽  
Ethical Perspective ◽  
Against Medical Advice ◽  
Discharge Against Medical Advice ◽  
Clinical Records

Discharge against medical advice (DAMA) is a common problem in the health-care system. It imposes risks to both patients and medical staff and could be the subject of ethical deliberation. This cross-sectional study was conducted in 2017 on 400 patients who were discharged against medical advice from the emergency ward of Shariati Hospital, Tehran, Iran. Patients’ information was collected using clinical records and telephone calls. The collected data were analyzed using STATA software. DAMA rate was 12% in the emergency department of Shariati Hospital. Male gender was found to be a risk factor for DAMA (OR: 1.90; CI (95%): 1.44 - 2.52; P < 0.0001). In addition, younger patients were more likely to leave hospital against medical advice (p-value: 0.04). The more common reasons for DAMA were feeling better, long delay in diagnostic and therapeutic procedures and the hectic ambience of the emergency ward. Patients’ self-discharge is a multi-dimensional phenomenon that is affected by patients’ characteristics, medical conditions and hospital circumstances. It raises some ethical concerns, mainly due to a conflict between patients’ autonomy and beneficence. It is helpful for the medical staff to create an effective relationship with patients who are at higher risk of DAMA, in order to increase their compliance and prevent the consequences of leaving hospital against medical advice.

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