Abstract
Background: Discharge against medical advice (DAMA) is a significant issue that causes problems for the patient and the hospital. It is possible to improve healthcare quality by examining the causes and factors affecting DAMA. The present study investigated the causes of DAMA in the emergency department of Sina Hospital.
Methods: This cross-sectional study was conducted in the emergency department of Sina Hospital in Hamedan. The research population included 125 patients. A valid checklist was used to collect data. The information collected by the checklist included demographics, information related to hospitalization, and reasons for DAMA and re-admission of the patient after 15 days. Finally, the data were analyzed using SPSS version 24 statistical software.
Results: In this study, 125 DAMA patients were investigated, including 86 males with an average age of 30.48 years and an average length of hospitalization of 6.12 hours. Most of the patients were between 31 and 50 years old (70.4%) and married (62.2%). Furthermore, most of them were hospitalized (51.2%) or discharged (47.2%) during the night shift. The main reason for DAMA was the reasons related to the patient (60.8%), and the reasons related to the hospital staff (22.4%) and the condition of the hospital (16.8%) were in the next ranks. The main reasons related to the patient were the feeling of enough recovery, the desire to continue treatment at home (35.5%), and the desire to visit private centers (18.4%).
Conclusion: Given that the majority of discharge cases were related to patient-related issues, it is possible to reduce the rate of discharge against medical advice by using techniques such as informing patients about the treatment process, the problems of early discharge, equipping the hospital with diagnostic-therapeutic means, and controlling the quality of medical services.