Discharge against medical advice in emergency department of a general hospital in Tehran
Journal Title: International Research Journal of Applied and Basic Sciences - Year 2013, Vol 5, Issue 12
Abstract
Patients with against medical advice (AMA) discharge, are exposed to the risk of getting inadequate treatment and readmission. In The present study we studied AMA discharge rate and its reasons in addition to evaluating the effect of a consultation program on AMA discharge rate in Shohada-e-Tajrish hospital in Tehran. In two comparable consecutive periods of 12 weeks between Feb. and Jul. 2010, patients who decided to sign out of the emergency ward of Shohada-e-Tajrish hospital in Tehran Against medical advice (AMA), were invited to participate in this study. During the first period, A questionnaire was used to interview the participants for their reasons to leave the hospital. In the second period, the patients were also consulted by a physician and a trained nurse before discharge. AMA discharge rate and reasons of discharge was compared between the two study periods. Among 12843 patients who referred to the emergency department, 1516 patients (11.8%) were discharged with self-consent (Against Medical Advice). The main reasons for leaving the hospital against medical advice were: feeling better (78%) and looking for better care in another center, In the intervention group, 1178 of 14001 patients left the hospital against medical advice and the AMA discharge rate dropped to 9.41%. The main reason behind this decision was still feeling better which dropped to 84.4% of patients. However, the second most frequent reason (looking for better service in another hospital) slightly increased. AMA discharge poses a serious problem which may be addressed and decreased by properly educating the patients on the associated risks. More studies on the outcome of AMA discharge including quantitative studies are necessary to clarify all aspects of this risky phenomenon in emergency wards.
Authors and Affiliations
Mohammad Mehdi Forouzanfar (MD)| Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Shohadaye Tajrish Medical Center, Shahid Beheshti University of Medical Sciences., Behrooz Hashemi (MD)*| Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Shohadaye Tajrish Medical Center, Shahid Beheshti University of Medical Sciences. , Alireza Baratloo (MD)| Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Shohadaye Tajrish Medical Center, Shahid Beheshti University of Medical Sciences., Ali Arhamodolatabadi (MD)| Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences., Hamidreza Hatamabadi (MD)| Assosiated Professor of Emergency Medicine, Department of Emergency Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences., Ali Shahrami (MD)| Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences., Saeed Safari (MD)| Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Shohadaye Tajrish Medical Center, Shahid Beheshti University of Medical Sciences.
Keywords
Related Articles
- EP ID EP6065
- DOI -
- Views 341
- Downloads 7
An Investigation into Preparatory Strategic Factors on Talent Management (A Case Study of the Maritime Organization of Guilan Province)
The major purpose of this study is to evaluate the effects of the strategic factors of the organization upon the talent management; this major purpose is stated in form of six minor parts: evaluation of the effect of off...
Predicting Stock Price Changes of Tehran Artmis Company Using Radial Basis Function Neural Networks
Analyzing and predicting changes in stock prices are of most significant capabilities to enter the stock market. Due to their relative abilities in recognizing the behavior and changes of stock prices, technical and fund...
Evaluating the performance of municipal authority in relation to improving citizen satisfaction through balanced scorecard approach (The case of Urmia municipality)
The aim of the present study is to investigate the performance of Urmia municipality authority in relation to improving citizen satisfaction through balanced scorecard approach which was done through descriptive-survey m...
Relationship between Attachment to God and Trust with Psychological Vulnerability of Students with Mediating on Patience
The current research studies the relationship between attachment to God and trust with psychological vulnerability of students mediating focusing on patience. This research is a correlation one in which 192 Bachelor stud...
Examining the Role of Competitive Intelligence as the New Strategic Information Technology Process in Changing the Banking Industry (Case study: Urmia Banks)
The aim of the present study is to examine the role of competitive intelligence as the new strategic information technology process in changing the banking industry across Urmia banks. So, the study is that of the applie...