Discharge against medical advice （DAMA） is a serious problem in healthcare delivery, as it can lead to further complications of the diseases that patients are suffering from. This study aimed to evaluate the reasons...Discharge against medical advice （DAMA） is a serious problem in healthcare delivery, as it can lead to further complications of the diseases that patients are suffering from. This study aimed to evaluate the reasons for signing DAMA for children in a tertiary teaching hospital in Oman. A prospective study was performed through telephone interviews with the mothers of children who were DAMA during one year （November 2013-November 2014）. Out of 3,647 discharges in general pediatric wards, there were 38 cases of DAMA, giving a prevalence rate of 1%. The DAMA happened within 24 hours of admission in 63.8%. Around two thirds of the patients were infants （65.96%）. In some cases, the diagnosis at time of discharge was life threatening diseases. The most common reason for the DAMA as stated by the mothers was child improvement, based on clinical and laboratory findings （40.4%o）, while social problems attributed for 29.8% of DAMA. However, the reasons were not documented in the electronic medical files of 57.4% of the patients, 57.4% of the cases reported by the mothers to be better two weeks after DAMA and the remaining either remained the same, readmitted or were following up in the clinic. Despite the low prevalence rate of DAMA found in this study, this is a stressing phenomenon occurring in a tertiary hospital in Oman, thus, further studies should be conducted to establish specific protocols to protect children from such practices.展开更多
文摘Discharge against medical advice （DAMA） is a serious problem in healthcare delivery, as it can lead to further complications of the diseases that patients are suffering from. This study aimed to evaluate the reasons for signing DAMA for children in a tertiary teaching hospital in Oman. A prospective study was performed through telephone interviews with the mothers of children who were DAMA during one year （November 2013-November 2014）. Out of 3,647 discharges in general pediatric wards, there were 38 cases of DAMA, giving a prevalence rate of 1%. The DAMA happened within 24 hours of admission in 63.8%. Around two thirds of the patients were infants （65.96%）. In some cases, the diagnosis at time of discharge was life threatening diseases. The most common reason for the DAMA as stated by the mothers was child improvement, based on clinical and laboratory findings （40.4%o）, while social problems attributed for 29.8% of DAMA. However, the reasons were not documented in the electronic medical files of 57.4% of the patients, 57.4% of the cases reported by the mothers to be better two weeks after DAMA and the remaining either remained the same, readmitted or were following up in the clinic. Despite the low prevalence rate of DAMA found in this study, this is a stressing phenomenon occurring in a tertiary hospital in Oman, thus, further studies should be conducted to establish specific protocols to protect children from such practices.
