Factors Influencing Patients to Make the Decision to Discharge Themselves Against Medical Advice at Tertiary Hospitals: A Cross-Sectional Study

Sharif, Malak Al; Alatawi, Aeshah; Alqahtani, Abdulhadi M.; Alufi, Mohammed; Alghamdi, Faisal

doi:10.21203/rs.3.rs-876315/v1

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…The findings agree with the study of Sharif et al . [ 11 ], Fenny et al . [ 12 ], and Dalinjong and Laar [ 13 ], affirming that most insured individuals had reported extended wait periods, verbal abuse, not being physically examined, and prejudice (e.g., racial).…”

Section: Discussionmentioning

confidence: 99%

Incidence of patients leaving against medical advice in government-subsidized hospitals: a descriptive retrospective study

Pasay-an¹,

Mostoles²,

Villareal³

et al. 2022

Pan Afr Med J

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Introduction this study aimed to determine the prevalence of leaving against medical advice (LAMA) in the local context and the associated predictors to help develop effective strategies to reduce its likelihood. Methods this study employed a retrospective approach using medical records of the 16233 patients between 2016 and 2020 at various government-subsidized hospitals in the Hail region of Saudi Arabia. Results the prevalence of LAMA was the highest in 2019 (91.9%) and 2017 (21.45%) among insured and non-insured patients, respectively. Furthermore, it was the highest among patients aged 20-25 years and the lowest among patients aged 46 years and above. The incidence of LAMA was the highest (15.48% for males and 29.53% for females) in 2016. In 2016-2019, the most common reason for LAMA was “wanted medication only,” while in 2020, the “fear of infection with COVID-19” was the main reason. High blood sugar was the most common diagnosis among the patients under consideration during the study period. Significant association was found between LAMA and patient's insurance status (t = 4.3123; p < 0.002); however, no association was found between LAMA and age (t = -0.8748; p > 0.658) and gender of patients (t = 1.9008; p > 0.302). Conclusion strategies such as developing a suitable environment for patients and taking due care of their needs, providing individual consulting services, enhancing staff relations, and providing support to patients in need are vital. The likelihood of LAMA can be minimized by informing hospitalized patients and their relatives about the adverse effects of LAMA.

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Section: Discussionmentioning

confidence: 99%

Incidence of patients leaving against medical advice in government-subsidized hospitals: a descriptive retrospective study

Pasay-an¹,

Mostoles²,

Villareal³

et al. 2022

Pan Afr Med J

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“…Predictors of DAMA, such as younger age, male sex, substance abuse, psychological disorders, and a lack of health insurance have been reported in the literature [7]. DAMA exposes the patient to the risk of an insufficiently treated medical problem, which could very easily lead to re-admission and extended morbidity-something that could happen in the next few days to weeks-and it may lead to a longer length of hospital stay for any readmission [6] [8].…”

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confidence: 99%

Factors Influencing Patients to Decide to Discharge Themselves against Medical Advice at Tertiary Hospitals: A Cross-Sectional Study

Alsharif¹,

Alatawi²,

Alqahtani³

et al. 2023

IJCM

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Background: Discharged against medical advice (DAMA) is defined as any instance when a patient wants to leave the hospital against the managing physician's decision. This study aimed to identify factors that influence patients to decide to be DAMA. Methods: A descriptive, cross-sectional study. The study was conducted in the emergency department (ED) of King Fahad Medical City (KFMC)-Saudi Arabia-Riyadh city. A questionnaire in both Arabic and English was distributed to all participants to fill in either English or Arabic. Results: Between 1 March and 30 April 2021, 510 responses were collected. Most of the study participants (31.4%) were over the age of 54. Our findings showed that 12.5% of our participants had taken discharge against medical advice in the past. Results Regarding Factors That Influence Patients to Decide on DAMA Showed: Regarding Inappropriate behavior and disrespect of the physician or staff to the patient and his relatives, 262 (51.4%) participants, 85 (16.7%) participants, and 163 (32%) participants agreed, neutral, and disagreed, respectively. Regarding the Lack of physicians' and nurses' attention to the patient and his relatives (emotionally), our result showed that 278 (54.5%) participants, 95 (18.6%) participants, and 137 (26.9%) participants agreed, neutral, and disagree, respectively. Regarding failure to inform the patient or his relatives of his condition, it showed that 257 (50.4%) participants, 95 (18.6%) participants, and 158 (31%) participants agreed, neutral, and disagreed, respectively. Regarding feeling better from DAMA, our result showed 226 (44.3%) participants, 119 (23.3%) participants, and 165 (32.4%) participants agreed, neutral, and disagreed, respectively. Regarding patients' or their relative's tiredness of hospital stay, the result showed that 166 (32.

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Factors Contributing to Leaving against Medical Advice (LAMA): A Consideration of the Patients’ Perspective

et al. 2023

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It is essential to understand why patients choose to leave the hospital in direct opposition to medical advice. This understanding could help to identify individuals who are at risk of adverse outcomes. In realizing this need, this study aimed to explore the factors contributing to the decision of patients to leave the hospital against medical advice. Materials and Methods: This research employed a descriptive-analytical approach. It was conducted in the city of Hail, Kingdom of Saudi Arabia. The participants were 13 patients who had opted to leave against medical advice from the Emergency Department of the government-subsidized hospitals. The researchers employed both purposive and snowball sampling. In snowball sampling, the researchers used referrals from initial participants to generate additional participants. Moreover, purposive sampling was used to find the individual that would best contribute to addressing the research issue. The data gathering was conducted from April to June 2022. Results: Five themes emerged based on the accounts of the 13 participant patients. These included (1) health literacy, (2) self-diagnosing, (3) unclear explanations regarding their condition, (4) prolonged waiting times, and (5) communication issues. Conclusion: The factors contributing to patients leaving against medical advice resulted in the five themes mentioned above. While interactions between patients and healthcare professionals may be challenging, pertinent health information must still be handed down clearly to patients.

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Factors Influencing Patients to Make the Decision to Discharge Themselves Against Medical Advice at Tertiary Hospitals: A Cross-Sectional Study

Cited by 3 publications

References 8 publications

Incidence of patients leaving against medical advice in government-subsidized hospitals: a descriptive retrospective study

Incidence of patients leaving against medical advice in government-subsidized hospitals: a descriptive retrospective study

Factors Influencing Patients to Decide to Discharge Themselves against Medical Advice at Tertiary Hospitals: A Cross-Sectional Study

Factors Contributing to Leaving against Medical Advice (LAMA): A Consideration of the Patients’ Perspective

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