Discharge against medical advice from the emergency department in a university hospital
Dublin Core
Title
Discharge against medical advice from the emergency department in a university hospital
Subject
Discharge against medical advice, Emergency medicine, Bahrain, Middle East, DAMA
Description
Background: Patients discharged against medical advice (DAMA) act as a high-risk population for the Emergency
Department (ED), regardless of their presentations, and can pose a serious burden for the hospital. This study
examines the prevalence, demographic and clinical characteristics, reasons, and clinical outcomes of a small sample
of DAMA patients in a teaching university hospital, including readmission, morbidity, and mortality.
Methods: A prospective, descriptive cross-sectional study was conducted in the ED of King Hamad University
Hospital (KHUH) with 98,992 patient visits during a 1-year period from June 2018 to June 2019. Consenting DAMA
patients were asked to complete a data collection form.
Results: Patients (n = 413) had a mean age of 44.1 years with a female majority (57.1%). The majority were
categorized as triage level-3 (87.7%). The main reasons for DAMA included refusal of the procedure/operation
(23.2%), long ED waiting time (22.2%), subjective improvement with treatment (17.7%), and children at home
(14.8%), whereas the least selected reason was dissatisfaction with medical care (1.2%). Follow-up of DAMA patients
revealed that 86 cases (20.8%) were readmitted to the ED within 72 h of which 41 (47.7%) cases were morbidity
and 2 (2.3%) were mortality. Marital status was a predictor of DAMA patients who revisit the ED within 72 h.
Conclusion: The results act as a pilot study to examine a small sample of DAMA patients’ characteristics, diagnosis,
and ED revisits. Hospitals should investigate further the DAMA population o
Department (ED), regardless of their presentations, and can pose a serious burden for the hospital. This study
examines the prevalence, demographic and clinical characteristics, reasons, and clinical outcomes of a small sample
of DAMA patients in a teaching university hospital, including readmission, morbidity, and mortality.
Methods: A prospective, descriptive cross-sectional study was conducted in the ED of King Hamad University
Hospital (KHUH) with 98,992 patient visits during a 1-year period from June 2018 to June 2019. Consenting DAMA
patients were asked to complete a data collection form.
Results: Patients (n = 413) had a mean age of 44.1 years with a female majority (57.1%). The majority were
categorized as triage level-3 (87.7%). The main reasons for DAMA included refusal of the procedure/operation
(23.2%), long ED waiting time (22.2%), subjective improvement with treatment (17.7%), and children at home
(14.8%), whereas the least selected reason was dissatisfaction with medical care (1.2%). Follow-up of DAMA patients
revealed that 86 cases (20.8%) were readmitted to the ED within 72 h of which 41 (47.7%) cases were morbidity
and 2 (2.3%) were mortality. Marital status was a predictor of DAMA patients who revisit the ED within 72 h.
Conclusion: The results act as a pilot study to examine a small sample of DAMA patients’ characteristics, diagnosis,
and ED revisits. Hospitals should investigate further the DAMA population o
Creator
Feras H. Abuzeyad , Moonis Farooq, Salah Farhat Alam, Mudhaffar Ismael Ibrahim, Luma Bashmi, Shaikha Sami Aljawder, Najeh Ellouze, Abdulla Almusalam, Stephanie Hsu and Priya Das
Publisher
BMC Emergency Medicine
Date
(2021) 21:31
Contributor
Fajar Bagus W
Format
PDF
Language
Indonesia
Type
Text
Files
Collection
Citation
Feras H. Abuzeyad , Moonis Farooq, Salah Farhat Alam, Mudhaffar Ismael Ibrahim, Luma Bashmi, Shaikha Sami Aljawder, Najeh Ellouze, Abdulla Almusalam, Stephanie Hsu and Priya Das, “Discharge against medical advice from the emergency department in a university hospital,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/3765.