ArticleAnnals of Saudi medicine
Discharge against medical advice in pediatrics: a 10-year retrospective analysis in a tertiary care center.
Article in Annals of Saudi medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Prevalence, Reasons, and Determinants of Discharge Against Medical Advice Among Hospitalized Pediatric Patients at the University of Gondar Comprehensive Specialized Hospital: A Prospective Observational Study.Health science reports · 2026Article
- Leaving without being seen and against medical advice from the pediatric emergency department: a single-center retrospective cohort study in Türkiye.European journal of pediatrics · 2026Article
- Discharge against medical advice among pediatric patients: A retrospective study from a Saudi tertiary emergency department.Saudi medical journal · 2025Article
- Caregivers' reasons and health professionals' perceptions of pediatric discharge against medical advice in Eastern Ethiopia: a mixed-methods study.BMC pediatrics · 2025Article
- Article
- Patient Satisfaction and Its Determinants in Outpatient Clinics of Ministry of Health Maternal and Child Hospitals in Saudi Arabia: A Survey Analysis.Inquiry : a journal of medical care organization, provision and financingArticle
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is still limited data on Discharge Against Medical Advice (DAMA) in the pediatric population. Most research comes from low-and middle-income countries, where the financial burden associated with medical care is often an important reason to leave a healthcare facility prematurely. Discharge against medical advice in the children's population is considered a significant issue that may lead to an increased risk of morbidity and mortality.
objectivesDescribe the characteristics and predictors of DAMA in children over ten years in in Riyadh, Saudi Arabia.
designRetrospective.
settingTertiary care center. PATIENTS AND
methodsThis study included all patients aged <14 years who had DAMA during all admissions between 1 January 2012, and 31 December 2022.
main outcome measuresData was retrieved from medical records and included 1) sociodemographic data, 2) medical history and clinical characteristics, 3) utilization of services during the admission leading to DAMA, and 4) interventions provided to prevent departure. SAMPLE SIZE: 355 DAMA episodes.
resultsMales accounted for 45.4%, and the average age was 4.4 years. The overall DAMA prevalence of was 0.4%. At baseline, 277 children (78%) had at least a chronic illness or severe baseline condition; 59% had a potential life-limiting or life-threatening condition. Reasons for DAMA included disagreement about the treatment plan (14.9%), social reasons (12.6%), and perception that the child's condition improved (5.6%). An increased risk of DAMA recurrence was associated with pre-existing severe or chronic medical conditions (OR: 8.2,
conclusionsDespite inconsistent documentation, preventive measures included the involvement of healthcare providers, social services, and patient relations. The study highlights the need for standardized protocols and improved documentation practices to effectively address discharge against medical advice. LIMITATIONS: Needs to moderate documentation quality of DAMA episodes. The study was limited to a single center, which may affect the generalizability. Children might also have presented to receive care in another facility post-DAMA.
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