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

Pasay-an, Eddieson; Mostoles, Romeo; Villareal, Sandro; Saguban, Reynita

doi:10.11604/pamj.2022.42.163.35161

Cited by 2 publications

(1 citation statement)

References 25 publications

(37 reference statements)

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“…23 In most cases, Paul et al found out that the frequency and causes for LAMA vary according to the ailment, geographical region, and type of healthcare system. 24 All of these problems were worsened by the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and clinical characteristics of adult patients presenting to a low resource, tertiary care emergency department in Pakistan: Challenges & Outcomes

Farooq,

Kazi,

Saleem

et al. 2023

Pak J Med Sci

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Objectives: Emergency Departments (EDs) play a major role in managing acute and chronic illnesses, especially in low-to-middle-income countries like Pakistan, which lacks effective primary healthcare. This study reports the epidemiology and clinical characteristics of patients presenting over a two-year period at the Indus Hospital and Health Network (IHHN) adult ED in Karachi, Pakistan. Methods: This is a retrospective observational study conducted through chart review of 264,859 patients, aged 16 years and above, who presented to the IHHN ED, Korangi Campus, from January 2019 to December 2020 after obtaining approval from IHHN IRB. Results: Men were found to be the predominant presenting gender, with a slight rise in the number of women in 2020. The most frequent age group in 2019 was 15-25 (27.7%), whereas it was 25-35 years in 2020 (24.1%), with a decline in total number of elderly visits seen in comparison to previous years. The most frequently seen disposition was ‘referral to clinic’ in 2019 (48.4%) and ‘discharged’ in 2020 (39%). Out of all dispositions, maximum Length of stay (LOS) was seen in patients who left against medical advice in both years. Patient acuity showed the highest number of P3 (moderately ill) patients in both years. Infectious diseases accounted for greater than 10% of patients in both years (17.2% and16.5%), followed by gastrointestinal complaints (15.7% and 11.3%), genitourinary complaints (14.9% and 7.9%), and trauma (11.9% and 12.4%). Conclusion: Knowledge of epidemiology and clinical characteristics of patients can help facilitate timely planning of staff deployment and allocation of resources to avoid overcrowding, improve patient outcomes, and increase patient satisfaction through timely management. doi: https://doi.org/10.12669/pjms.40.2(ICON).8975 How to cite this: Farooq W, Kazi K, Saleem SG, Ali S. Epidemiology and clinical characteristics of adult patients presenting to a low resource, tertiary care emergency department in Pakistan: Challenges & Outcomes. Pak J Med Sci. 2024;40(2):S21-S27. doi: https://doi.org/10.12669/pjms.40.2(ICON).8975 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and clinical characteristics of adult patients presenting to a low resource, tertiary care emergency department in Pakistan: Challenges & Outcomes

Farooq,

Kazi,

Saleem

et al. 2023

Pak J Med Sci

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

Cited by 2 publications

References 25 publications

Epidemiology and clinical characteristics of adult patients presenting to a low resource, tertiary care emergency department in Pakistan: Challenges & Outcomes

Epidemiology and clinical characteristics of adult patients presenting to a low resource, tertiary care emergency department in Pakistan: Challenges & Outcomes

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

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