ArticleClinical and experimental emergency medicine2016
Patients who leave the emergency department against medical advice.
Article in Clinical and experimental emergency medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Effectiveness of a digital game based study guide on head trauma assessment on knowledge and practical skills of nursing students: a quasi-experimental study.BMC medical education · 2025Trial
- Confronting Patients' Refusal to Undergo Treatment: A Cross-Sectional Study of Ethical Attitudes and Intended Behaviour Among Lithuanian Physicians.Healthcare (Basel, Switzerland) · 2025Article
- Discharge Against Medical Advice From the Emergency Department: Results From a Private Hospital in Beirut.Cureus · 2025Article
- Article
- Quantitative Analysis of Characteristics Associated with Patient-Directed Discharges, Representations, and Readmissions: a Safety-Net Hospital Experience.Journal of general internal medicine · 2024Article
- [Toxico-surveillance at Emergency Department: First Annual Report].Jugan geon-gang gwa jilbyeong · 2024Article
- 'But what if you miss something …?': factors that influence medical student consideration of cost in decision making.BMC medical education · 2023Article
- Factors Contributing to Leaving against Medical Advice (LAMA): A Consideration of the Patients' Perspective.Healthcare (Basel, Switzerland) · 2023Article
- COVID-19 outbreak impact on discharge against medical advice from the ED: A retrospective study.The American journal of emergency medicine · 2022Article
- Development and validation of a scoring system for mortality prediction and application of standardized W statistics to assess the performance of emergency departments.BMC emergency medicine · 2021Article
- Characteristics of trauma patients that leave against medical advice: An eight-year survey analysis using the National Hospital Ambulatory Medical Care Survey, 2009-2016.Journal of clinical orthopaedics and trauma · 2021Article
- Discharge against medical advice from the emergency department in a university hospital.BMC emergency medicine · 2021Article
- Why Do Patients Leave against Medical Advice? Reasons, Consequences, Prevention, and Interventions.Healthcare (Basel, Switzerland) · 2021Review
- Discharge against medical advice among neurological patients: Characteristics and outcomes.Health services research · 2020Article
- Changes in Demographic and Diagnostic Spectra of Patients with Neurological Symptoms Presenting to an Emergency Department During the COVID-19 Pandemic: A Retrospective Cohort Study.Neuropsychiatric disease and treatment · 2020Article
- Uncompleted emergency department care and discharge against medical advice in patients with neurological complaints: a chart review.BMC emergency medicine · 2019Article
- Mortality and repeated poisoning after self-discharge during treatment for acute poisoning by substances of abuse: a prospective observational cohort study.BMC emergency medicine · 2019Observational
- "Should I stay or Should I go": patient who leave Emergency Department of an Italian Third-Level Teaching Hospital.Acta bio-medica : Atenei Parmensis · 2018Observational
- Refusal of the hospitalization: a distressed dilemma in obstetric practice.Therapeutic advances in reproductive healthArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDischarge against medical advice (DAMA) from the emergency department (ED) accounts for 0.1% to 2.7% of all ED discharges. DAMA carries a risk of increased mortality and readmissions. Our aim was to investigate the general characteristics of DAMA patients and the differences between them and non-DAMA patients.
methodsWe reviewed data collected by the National Emergency Medical Center between 2010 and 2011. Subjects were categorized into 2 groups, namely, the DAMA group and the non-DAMA group. We compared these groups with respect to age, gender, trauma or non-trauma status, type of hospital, health insurance, level of consciousness on admission, and diagnosis.
resultsOf 8,000,529 patients, 222,389 (2.78%) left against medical advice. The risk factors for DAMA across all age groups were as follows: no medical insurance (odds ratio [OR], 1.993), initial response to voice (OR, 2.753) or pain (OR, 2.101), trauma admission (OR, 1.126), admission to a local emergency medical center (OR, 1.215), and increased age. A high risk of DAMA was observed among patients with immune, endocrine, psychiatric, neurological, circulatory diseases, and external causes of morbidity and mortality.
conclusionAlthough DAMA cases account for only a small percentage of hospital discharges, they are important because DAMA patients have high readmission and mortality rates. It is therefore important to understand the general characteristics and predictors of DAMA in order to improve patient outcome and minimize the economic burden on the healthcare system.
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