ArticleBMC emergency medicine2021
Discharge against medical advice from the emergency department in a university hospital.
Article in BMC emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Article
- Discharge against medical advice among pediatric patients: A retrospective study from a Saudi tertiary emergency department.Saudi medical journal · 2025Article
- Confronting Patients' Refusal to Undergo Treatment: A Cross-Sectional Study of Ethical Attitudes and Intended Behaviour Among Lithuanian Physicians.Healthcare (Basel, Switzerland) · 2025Article
- Article
- Initial Clinical Impressions Are Absent in Around a Quarter of Adult Emergency Department Patient Consultations: Let's Get Back to Basics.Emergency medicine Australasia : EMA · 2025Article
- Comparing Performance Outcomes of Emergency Medicine-Trained vs. Non-Emergency Medicine-Trained Physicians in Emergency Departments.Journal of acute medicine · 2025Article
- Discharge Against Medical Advice From the Emergency Department: Results From a Private Hospital in Beirut.Cureus · 2025Article
- The experiences of patients who leave hospital against medical advice: analysis of survey data.Frontiers in health services · 2025Article
- Discharge Against Medical Advice in Cancer Patients: Insights from a Multicenter Study in Germany.Cancers · 2024Article
- Article
- Understanding patients' decision to leave hospital care in Ghana: clinical cases and underlying determinants.BMC nursing · 2024Article
- Leaving emergency departments without completing treatment among First Nations and non-First Nations patients in Alberta: a mixed-methods study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Epidemiology and clinical characteristics of adult patients presenting to a low resource, tertiary care emergency department in Pakistan: Challenges & Outcomes.Pakistan journal of medical sciences · 2024Article
- 90-day Return to the Emergency Department Following Shoulder Arthroscopy: Prevalence, Risk Factors, and Reasons.The archives of bone and joint surgery · 2024Article
- Hospital and emergency department discharge against medical advice in Western Australian Aboriginal children aged 0-4 years from 2002 to 2018: A cohort study.Paediatric and perinatal epidemiology · 2023Article
- Association of limited English proficiency with emergency department irregular departures and return visits: A cross-sectional cohort study in the Upper Midwest between January 2018 and December 2021.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Analysis of factors affecting discharge with the personal consent of hospitalized patients: A cross-sectional study.Health science reports · 2023Article
- Article
- Article
- Factors Contributing to Leaving against Medical Advice (LAMA): A Consideration of the Patients' Perspective.Healthcare (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients discharged against medical advice (DAMA) act as a high-risk population for the Emergency Department (ED), regardless of their presentations, and can pose a serious burden for the hospital. This study examines the prevalence, demographic and clinical characteristics, reasons, and clinical outcomes of a small sample of DAMA patients in a teaching university hospital, including readmission, morbidity, and mortality.
methodsA prospective, descriptive cross-sectional study was conducted in the ED of King Hamad University Hospital (KHUH) with 98,992 patient visits during a 1-year period from June 2018 to June 2019. Consenting DAMA patients were asked to complete a data collection form.
resultsPatients (n = 413) had a mean age of 44.1 years with a female majority (57.1%). The majority were categorized as triage level-3 (87.7%). The main reasons for DAMA included refusal of the procedure/operation (23.2%), long ED waiting time (22.2%), subjective improvement with treatment (17.7%), and children at home (14.8%), whereas the least selected reason was dissatisfaction with medical care (1.2%). Follow-up of DAMA patients revealed that 86 cases (20.8%) were readmitted to the ED within 72 h of which 41 (47.7%) cases were morbidity and 2 (2.3%) were mortality. Marital status was a predictor of DAMA patients who revisit the ED within 72 h.
conclusionThe results act as a pilot study to examine a small sample of DAMA patients' characteristics, diagnosis, and ED revisits. Hospitals should investigate further the DAMA population on a larger scale, reasons for refusing procedures, and utilize this knowledge to improve the healthcare process.
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