Reasons for Discharge against Medical Advice among Patients Admitted to Ghaem Research-Training and Medical Center of Mashhad, Iran, in 2015 | ||
| Journal of Patient Safety & Quality Improvement | ||
| مقاله 5، دوره 6، شماره 1، فروردین 2018، صفحه 656-661 اصل مقاله (691.82 K) | ||
| نوع مقاله: Original Article | ||
| نویسندگان | ||
| Marjan Vejdani1؛ Yasamin Molavi Taleghani* 2 | ||
| 1Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar. Iran | ||
| 2Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. | ||
| چکیده | ||
| Introduction: Discharge against medical advice (DAMA) indicates the existence of serious problems in the quality of hospital services, which can exacerbate the disease and increase the risk of hospital readmission. This study was targeted toward examining the reasons for DAMA among the patients admitted to Ghaem Hospital of Mashhad, Iran, in 2015. Materials and Methods: This cross-sectional, descriptive study was conducted on 6,645 patients discharged from the Ghaem Hospital of Mashhad with their own personal desire in the first 9 months of 2015. Data collection was performed using the information recorded in the health information system of the hospital; in addition, the required information which was not available in this system were obtained via making a telephone call with the respondents. The data were analyzed using descriptive statistics in SPSS, version 22. Results:Out of the 53,558 patients admitted to Ghaem Hospital of Mashhad in the first nine months of 2015, 6,645 (12.4%) cases were discharged with their own desire. Regarding the reasons of DAMA, 13.1% and 86.7% of the patients had called for DAMA due to the reasons related to hospital and personal issues, respectively. Accordingly, the main reasons for DAMA were categorized into patient- and hospital-related reasons, including patient's personal and family reasons (41.8%) and overcrowding of wards (6.6%), respectively. Conclusion: Improved communication between physician and patient, patient’s increased awareness regarding the probable complications of early discharge, improved quality of hospital services, use of clinical aids, and designing green space and a pleasant environment are the recommended strategies to reduce the rate of DAMA. | ||
| کلیدواژهها | ||
| Discharge against medical advice؛ Hospital services؛ Quality Improvement | ||
| مراجع | ||
|
1- Taqueti VR. Leaving against medical advice. The New England journal of medicine. 2007 Jul 19;357(3):213-5.
2- Carrese JA. Refusal of care: patients' well-being and physicians' ethical obligations: "but doctor, I want to go home". JAMA : the journal of the American Medical Association. 2006 Aug 9; 296(6):691-5.
3- Gerbasi JB, Simon RI. Patients' rights and psychiatrists' duties: discharging patients against medical advice. Harvard review of psychiatry. 2003 Nov-Dec; 11(6):333-43.
4- Brook M, Hilty DM, Liu W, Hu R, Frye MA. Discharge against medical advice from inpatient psychiatric treatment: a literature review. Psychiatric services (Washington, DC). 2006 Aug;57(8):1192-8.
5- Henry B, Dunbar T, Barclay L, Thompson R. Selfdischarge against medical advice from Northern Territory Hospitals. Australia2007
6- Ibrahim SA, Kwoh CK ,Krishnan E. Factors Associated With Patients Who Leave Acute-Care Hospitals Against Medical Advice. American Journal of Public Health. 2007;97(12):2204-8.
7- Saitz R, Ghali WA, Moskowitz MA. The Impact of Leaving Against Medical Advice on Hospital Resource Utilization. Journal of general internal medicine. 2000;15(2):103-7.
8- Hwang SW, Li J, Martin RE. What happens to patients who leave hospital against medical advice? Canadian Medical Association Journal. 2003;168(4):417-20.
9- Anis AH, Sun H, O'Shaughnessy MV. Leaving hospital against medical advice among HIV-positive patients. Canadian Medical Association Journal. 2002;167(6):633-70.
10- Weingart SN, Davis RB, Phillips RS. Patients discharged against medical advice from a general medicine service. Journal of general internal medicine. 1998 Aug;13(8):568-71.
11- Saitz R, Ghali WA, Moskowitz MA. The impact of leaving against medical advice on hospital resource utilization. Journal of general internal medicine. 2000 Feb;15(2):103-7.
12- Tavallaei S. A, Asari Sh, Habibi M, Khodami H. R, Siavoshi Y, Nouhi S, Radfr Sh. Discharge Against Medical Active from Psychiatric Ward. Journal of Military Medicine. 2006;8(1):24-30.
13- Manouchehri J, Goodarzynejad H, Khoshgoftar Z, Fathollahi MS, Abyaneh MA. Discharge against Medical Advice among Inpatients with Heart Disease in Iran. The Journal of Tehran University Heart Center. 2012;7(2):72-7.
14- Green P, Watts D, Poole S, Dhopesh V. Why patients sign out against medical advice (AMA): factors motivating patients to sign out AMA. The American journal of drug and alcohol abuse. 2004 May;30(2):489-93.
15- Alfandre DJ. "I'm going home": discharges against medical advice .Mayo Clinic proceedings Mayo Clinic. 2009 Mar;84(3):255-60.
16- Shirani F, Jalili M, Asl ESH. Discharge against medical advice from emergency department: results from a tertiary care hospital in Tehran, Iran. European journal of emergency medicine : official journal of the European Society for Emergency Medicine. 2010 Dec;17(6):318-21.
17- Jeddi FR, jeddi MR, Rezaeiimofrad M. Patients’ Reasons for Discharge against Medical Advice in University Hospitals of Kashan University of Medical Sciences in 2008. Hakim Research Journal. 2010;13(1):33-9
18- Vahdat S, Hesam S, Mehrabian F. Effective factors on patient discharge with own agreement in selected Therapeutic Training Centers of Ghazvin Shahid Rajaei .Journal of Colleges of Nursing and Midwifery, Gilan. 2010;20(64).
19- Tolaee SA, Asari S, Habibi M, Khodami H. Discharge with own agreement of Psychiatry. Journal of Military Medicine. 2006;8(1):24-30.
20- Kabirzade A, Rezazade E, Saravi BM. Frequency and causes of discharge with own agreement in children in BUALI hospital-Sari. Journal of North Khorasan University of Medical Sciences. 2011;2(4):57-62. Vejdani et al (DAMA) of Patients in Ghaem Hospital 661 Patient Saf Qual Improv, Vol. 6, No. 1, Win 2018
21- Anis AH, Sun H, Guh DP, Palepu A, Schechter MT, O'Shaughnessy MV. Leaving hospital against medical advice among HIV-positive patients. CMAJ. 2002;167(6):633-7.
22- Berger JT. Discharge against medical advice: ethical considerations and professional obligations. Journal of hospital medicine : an official publication of the Society of Hospital Medicine 2112 .Sep;3(5):403-8.
23- Ebrahimipour H, Meraji M, Hooshmand E, Nezamdoust F, Molavi-Taleghani Y, Hoseinzadeh N, Vafaee-Najar A. Factors Associated with Discharge of Children from Hospital Against Medical Advice (AMA) at Doctor Sheikh Pediatric Hospital (DSPH) in Mashhad: 2011-2013. World Journal of Medical Sciences2014. 11 (2): 196-201. | ||
|
آمار تعداد مشاهده مقاله: 2,205 تعداد دریافت فایل اصل مقاله: 488 |
||