scholarly journals Discharge against medical advice amongst patients admitted into the Paediatric wards of the University of Port Harcourt Teaching Hospital

2012 ◽  
Vol 40 (1) ◽  
Author(s):  
GK Eke ◽  
PI Opara
Keyword(s):  
Teaching Hospital ◽  
Medical Advice ◽  
Against Medical Advice ◽  
Port Harcourt ◽  
Discharge Against Medical Advice ◽  
The University

Discharge against Medical Advice in Some Paediatric Wards

1988 ◽  
Vol 18 (3) ◽  
pp. 125-127 ◽  
Author(s):  
H S Goyea
Keyword(s):  
Hospital Care ◽  
Preventive Health Care ◽  
Medical Advice ◽  
Preventive Health ◽  
Against Medical Advice ◽  
The Poor ◽  
Discharge Against Medical Advice ◽  
The Cost ◽  
The University ◽  
Family Opposition

Sixty-four cases of discharge against medical advice (DAMA) from 3 paediatric units in the University of Benin Teaching Hospital within a period of 18 months were analysed. The incidence was highest among the very young, even when they were still very ill. Financial problems accounted for 65.6% of the cases. Other reasons included difficulties related to the siblings (9.4%), the wish to try traditional methods (7.8%), family opposition (1.6%) and distance from the hospital (4.1%). It is recommended that greater attention be given to preventive health care, and placing the cost of hospital care within the reach of the poor. Improved communication is also recommended as a way of helping parents seek alternatives to DAMA.

scholarly journals 780. Inpatient Addiction Medicine Consultations at the Urban/Rural Frontier: Improving Quality of Care and Linkage to Outpatient Services for Patients with Substance Use Disorder in Central Kentucky

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S346-S346
Author(s):  
Laura Fanucchi ◽  
Devin Oller
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Medical Advice ◽  
Outpatient Services ◽  
Addiction Medicine ◽  
Against Medical Advice ◽  
Opioid Treatment ◽  
Rural Counties ◽  
Discharge Against Medical Advice ◽  
The University

Abstract Background When persons with opioid use disorder (OUD) are hospitalized with medical complications (e,g. endocarditis, viral hepatitis) they frequently do not receive medications for the underlying OUD. In recent years, a number of hospitals have implemented addiction medicine consultation (AMC) services to help address this treatment gap, though these are all in large urban centers. AMCs provide comprehensive substance use disorder (SUD) assessments, manage SUDs, initiate pharmacotherapy for OUD, and arrange linkage to ongoing treatment. The aim of this study was to describe the initial implementation and outcomes of a new AMC at the University of Kentucky Hospital, a 945-bed tertiary referral center with a large rural catchment. Methods The Addiction Consultation and Education Service(ACES) began October, 2018 and was comprised of several physicians and an APRN. A patient navigator assisted with prior authorizations and outpatient linkage. ACES referred to a new bridge clinic at the University for ongoing office-based opioid treatment as well as to community programs and licensed opioid treatment programs. Patient demographics, SUD diagnoses, and comorbidities (including details of the injection-related infections) are collected from the electronic health record, as well as key process metrics including: time-to-consultation and medication initiation, length of stay(LOS), discharge against medical advice(AMA), and details of linkage to outpatient services. Results From October-December, 91 patients were seen, 73 met DSM-5 criteria for OUD, 82 had a medical complication of SUD, and 53 lived in rural counties (Rural-Urban Continuum Codes 4–9). Average LOS was 19.5 days. Among OUD patients, 71% underwent buprenorphine/naloxone induction, 9% were started on methadone. Less than 6% of patients started on buprenorphine or methadone left against medical advice. Conclusion AMCs are a key part of providing comprehensive care for persons hospitalized with infectious complications of substance use. Initiating medication for OUD likely decreases rates of discharge against medical advice. Compared with other AMCs, a greater percentage of patients seen by ACES resided in rural counties. Establishing a bridge clinic prior to starting an AMC is critical to ensure ongoing care. Disclosures All authors: No reported disclosures.

Discharge against Medical Advice

2002 ◽  
Vol 32 (3) ◽  
pp. 149-151 ◽  
Author(s):  
E C Ohanaka
Keyword(s):  
Clinical Condition ◽  
Medical Advice ◽  
Surgical Patients ◽  
Long Bones ◽  
Age Group ◽  
Common Condition ◽  
Against Medical Advice ◽  
Discharge Against Medical Advice ◽  
The University ◽  
Age Range

An audit of surgical patients who requested discharge against medical advice over a 5 year period (July 1996–July 2001) at the University of Benin Teaching Hospital showed that 78 patients (66 males and 12 females) were involved. The age range was 3 days to 85 years (mean 37.86 years). The 21–40 age group was the most involved. Trauma in general accounted for the most common clinical condition that caused a patient to discharge against medical advice (64 or 82%), while fracture involving the long bones was the most common condition (37 or 47.4%). The plausible reasons for this practice have been outlined including measures that may help to reduce discharge against medical advice in a developing country.

Discharge against medical advice from a Tehran emergency department

2016 ◽  
Vol 29 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Azar Hadadi ◽  
Patricia Khashayar ◽  
Mojgan Karbakhsh ◽  
Ali Vasheghani Farahani
Keyword(s):  
Emergency Department ◽  
Teaching Hospital ◽  
Cross Sectional Study ◽  
Medical Advice ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Against Medical Advice ◽  
Policy Makers ◽  
Content Type ◽  
Discharge Against Medical Advice

Purpose – The purpose of this paper is to identify the main reasons for discharge against medical advice (DAMA) in the emergency department (ED) of a teaching hospital in Tehran, Iran. Design/methodology/approach – This cross-sectional study was conducted on all the patients who left the ED of a referral teaching hospital against medical advice (AMA) in 2008. A questionnaire was filled out for each patient to determine the reasons behind patient leaving AMA. Findings – In total, 12.8 percent of the patients left the hospital AMA. Dissatisfaction with being observed in the ED, having a feeling of recovery and hospital personnel encouraging patients to leave the hospital were the main reasons for leaving the hospital AMA. Practical implications – Like many other centers, the results showed that poor communication skill and work overload were the main contributing factors to DAMA. The center managed to improve patient satisfaction and thus lowered DAMA rates following this study. Considering the similarities reported in the reports and that of other studies, it could be concluded that policy makers in other centers can also benefit from the results to adopt effective approaches to reduce DAMA rate. Originality/value – To the knowledge no study has evaluated the rate and the reasons behind DAMA in the Iranian EDs.

scholarly journals Characteristics and outcome of road traffic injured patients in the emergency department of a tertiary teaching hospital in Nigeria

2021 ◽  
Vol 7 (3) ◽  
pp. 451
Author(s):  
Oludolapo O. Afuwape ◽  
Temitope O. Alonge ◽  
Achiaka E. Irabor ◽  
Mosi J. Balogun
Keyword(s):  
Emergency Department ◽  
Teaching Hospital ◽  
Road Traffic ◽  
Road Traffic Injury ◽  
Medical Advice ◽  
Against Medical Advice ◽  
Traffic Injury ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Discharge Against Medical Advice

<p class="abstract"><strong>Background:</strong> The exit modes from the emergency department (ED) for road traffic injury patients are namely planned discharge; admission to the wards/intensive care unit or transfer to the operating theatre; discharge against medical advice (DAMA). The aim of this study was to assess the characteristics and outcomes of non-poly-traumatized road traffic injury (RTI) related ED admissions of a tertiary health care facility in a developing country and the exit pattern from the ED.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective hospital data-based study of outcome of RTI patients seen in the ED of a tertiary teaching hospital in Nigeria from January to December 2017.<strong></strong></p><p class="abstract"><strong>Results:</strong> 1120 RTI patients were recruited consisting of 774 males and 346 females with a male: female ratio of 2.24:1. The age range was 1 to 94 years with a mean age of 37.5±17.5 years.  Peak ages were in the fourth (24.2%) and third (20.4%) decades of life respectively.  85.5% of the patients were commercial vehicles passengers. Motorcycle accidents constituted 44% of the patients while 41.8% were in cars. The commonest injuries were head injuries (31% m:f 2.7) and fractures (21% m:f 3). There were 11.5% DAMA and 7.1% deaths. Motorcycles injuries had the highest mortality rate while the motorized tricycles injuries had the highest DAMA rates.</p><p class="abstract"><strong>Conclusions:</strong> Motorized tricycles may be considered as a safer means of commercial mode of transportation compared to motorcycles despite its own limitations. There is a need to educate patients against the common practice of discharge against medical advice.</p>

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