ArticleThe American journal of emergency medicine2022
COVID-19 outbreak impact on discharge against medical advice from the ED: A retrospective study.
Article in The American journal of emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Disparities in Discharge Support Provided to Patients Leaving "Before Medically Advised" from Hospitalization for Chronic Obstructive Pulmonary Disease Exacerbation.Annals of the American Thoracic Society · 2025Article
- Socioeconomic differences in discharge against medical advice and hospital admission among emergency department visits associated with substance use in the United States.Frontiers in public health · 2025Article
- Incidence of Discharge Against Medical Advice in Queensland Hospital Emergency Departments Among Indigenous Patients from 2016 to 2021.Journal of racial and ethnic health disparities · 2024Article
- Quantitative Analysis of Characteristics Associated with Patient-Directed Discharges, Representations, and Readmissions: a Safety-Net Hospital Experience.Journal of general internal medicine · 2024Article
- Incidence of patients leaving against medical advice in government-subsidized hospitals: a descriptive retrospective study.The Pan African medical journal · 2022Article
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Authors and funding
2 authors.
Funding
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Abstract
backgroundThe COVID-19 pandemic has profoundly affected the habits of patients, as well as its negative effects on human health. The aim of this study is to investigate the factors associated with discharge against medical advice (DAMA) from the emergency department (ED) during the COVID-19 pandemic.
methodsWe conducted a retrospective study of the charts of DAMA cases (pandemic group) between May 1 and October 30, 2021 in a tertiary hospital in Istanbul, Turkey. Our data were compared with DAMA cases between May 1 and October 30, 2019 (pre-pandemic group-control group).
resultsDuring the pandemic period, DAMA cases increased by 24.5% in the ED compared to the previous period. Compared to the pre-COVID-19 period, among DAMA cases during the COVID-19 period, the rate of those arriving by ambulance (10.9 vs. 18.8%), those with one or more comorbid diseases (8.9 vs. 18.4%), those with a high triage level (4.0 vs. 7.4%), those with health tourism or refugee/asylum insurance (2.9 vs. 6.1%), those with trauma (11.5 vs. 19.9%) or alcohol/drug abuse (2.7 vs. 4.0%) increased significantly (p < 0.001). It was observed that DAMA cases' waiting times for total ED and from the door to doctor decreased during the pandemic period compared to the pre-pandemic period.
conclusionDuring the COVID-19 pandemic period, it was observed that the rate of those with severe disease increased among DAMA cases. Necessary precautions should be taken for all patients, especially seriously ill patients, to feel safe in the hospital and to be treated, and the negative consequences that may develop should be prevented by addressing the concerns of the patients and their relatives.
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