ArticleAfrican journal of emergency medicine : Revue africaine de la medecine d'urgence2025
Magnitude and associated factors of discharge against medical advice among patients treated in the adult Emergency Department at an Ethiopian University Hospital.
Article in African journal of emergency medicine : Revue africaine de la medecine d'urgence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
- Erratum issued
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Discharge against medical advice (DAMA) is a global phenomenon in which patients voluntarily terminate their consent to medical care before the medical team declares them fit for discharge. This adversely affects the delivery of quality health care and poses serious clinical, ethical, and legal challenges to the individual physician and the hospital. This study aims to assess the magnitude and factors associated with DAMA. Methods: An institution-based cross-sectional study was conducted at the adult emergency department of Hawassa University Comprehensive Specialized Hospital, Ethiopia. A systematic random sampling technique was used to select 322 patients. The data were collected using a pretested, structured checklist through chart review. Descriptive statistics, including proportions, medians, tables, and charts, were used to describe the characteristics of the study participants. Binary logistic regression analysis was used to identify factors associated with DAMA. The model's fitness was checked by the Hosmer and Lemeshow tests. The significance level was declared at a p-value < 0.05. Results: This study found that the magnitude of DAMA was 7.45 % (24 out of 322); 95 % CI: 4.56-10.3 %) The majority of patients with DAMA 1041.7 %) were due to a financial issue, followed by the refusal of procedure 5, 20.8 %) and poor prognosis 4, 16.7 %). Being male [AOR: 4.1; 95 % CI: 1.17-14.11] and triage levels of Red and Orange [AOR: 2.87; 95 % CI: 1.02- 8.02] were associated with DAMA. Conclusion: The study identified a considerable magnitude of DAMA. Being male and the severity of the triage score were found to be independent determinants of DAMA. The majority of patients had permanently left the hospital due to financial constraints. Therefore, strengthening health insurance and ensuring the availability of the necessary resources at government health facilities could help reduce DAMA.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.