Background: Discharge against medical advice (DAMA) occurs when the patient or their caretaker leaves the hospital against the recommendation of their treating physician. DAMA may expose the children to a high risk of inadequate treatment, which may result in readmission, prolonged morbidity, and mortality. The study aimed to identify the predictors of DAMA in the emergency department (ED) within the pediatric age group. Methods: This was a cross-sectional study. The study used the medical records of pediatric patients ( n = 5609) that were admitted to the ED of King Abdullah Bin Abdulaziz University Hospital (KAAUH) in Riyadh, Saudi Arabia, during 2017 and 2018. Descriptive statistics, Chi-square, or Fisher's exact test were used. Unadjusted and adjusted odds ratios with their 95% CI were reported by performing logistic regression modeling. Results: A significant interaction between age and gender was observed in the multivariate analysis after adjusting for the other covariates. The odds of DAMA for a 5-year-old female child were 4.43 times higher than those of a 5-year-old male child ( P < 0.1). Conclusions: The public should be educated about the consequences of DAMA. Continued health education and the promotion of child survival strategies at the community level, combined with an improvement in the socioeconomic conditions of the population, may further reduce DAMA and improve the chances of survival for children. Future studies should assess the socioeconomic status of the patients and estimate the cost that is incurred by the patients.
Length-of-stay is an important quality measure for emergency departments. The study aimed to find predictors for prolonged LOS in children. A cross sectional study was conducted from Jan 2017 to Mar 2018. Data were extracted from medical records of 5609 pediatric patients admitted to the King Abdullah Bin Abdulaziz University Hospital-ED, Riyadh, Saudi Arabia. Median LOS of the children was 74 mins. Multivariable analysis showed the difference in the expected LOS between patients DAMA and their non-DAMA counterparts was 72 mins. Difference in the expected LOS between patients at emergent and non-urgent triage was 89 mins, between urgent and non-urgent triage was 51 mins and difference between less urgent and non-urgent triage was 16 mins. Future studies should explore the contributing managerial and clinical factors that can explain such associations and might be the focus for future policy changes to reduce LOS in ED pediatric settings in Saudi Arabia.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.