Factors associated with discharge against medical advice from Emergency Department, Universiti Kebangsaan Malaysia Medical Centre

Patients who self-discharge against medical advice (DAMA) are susceptible to life-threatening consequences. By understanding the factors associated with DAMA, healthcare centres can build strategies to assist patients to receive optimal medical care and prevent unfavourable outcome. The objective of...

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Main Authors:	Ahmad Khaldun Ismail, Mohamad Ali S, Che’ Man Z
Format:	Article
Language:	English
Published:	Fakulti Perubatan, UKM 2016
Online Access:	http://journalarticle.ukm.my/9785/ http://journalarticle.ukm.my/9785/ http://journalarticle.ukm.my/9785/1/5._Ismail_et_al.pdf

id	ukm-9785
recordtype	eprints
spelling	ukm-97852016-12-14T06:50:50Z http://journalarticle.ukm.my/9785/ Factors associated with discharge against medical advice from Emergency Department, Universiti Kebangsaan Malaysia Medical Centre Ahmad Khaldun Ismail, Mohamad Ali S, Che’ Man Z, Patients who self-discharge against medical advice (DAMA) are susceptible to life-threatening consequences. By understanding the factors associated with DAMA, healthcare centres can build strategies to assist patients to receive optimal medical care and prevent unfavourable outcome. The objective of this study was to determine the factors associated with DAMA from the Emergency Department (ED) of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This was a prospective unmatched case control study conducted over a 4-month period. For every DAMA episode, two patients who were admitted on the same day were randomly selected as control. Following patient consent, data was collected using a standardized questionnaire. Patients were contacted by the investigator for information regarding hospitalization within two weeks of DAMA. Ninety three patients were recruited; 31 DAMA patients and 62 admitted patients. Payment method was significantly associated with DAMA (OR 3.17 95% CI 1.29-7.98; p=0.01). The likelihood of self-paying patients to take DAMA was three times higher than those who had a guarantor letter from their employer or insurance provider. Other factors which influence DAMA were family obligations (OR 4.08 95% CI 1.09-15.26; p = 0.03) and work problems (OR 3.83 95% CI 1.13-12.94; p=0.03). A total of 19.4% of DAMA patients left following symptomatic pain relief. A total of 80.6% DAMA patients were admitted to hospital within two weeks of the DAMA episode. Payment method significantly influences DAMA. Payment planning, social welfare services, non-governmental organization funds and the introduction of a national health policy scheme may aid hospital payment, alleviate financial limitation of patients and reduce DAMA episodes. Fakulti Perubatan, UKM 2016 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/9785/1/5._Ismail_et_al.pdf Ahmad Khaldun Ismail, and Mohamad Ali S, and Che’ Man Z, (2016) Factors associated with discharge against medical advice from Emergency Department, Universiti Kebangsaan Malaysia Medical Centre. Medicine & Health, 11 (1). pp. 29-37. ISSN 1823-2140 http://www.medicineandhealthukm.com/toc/11/1
repository_type	Digital Repository
institution_category	Local University
institution	Universiti Kebangasaan Malaysia
building	UKM Institutional Repository
collection	Online Access
language	English
description	Patients who self-discharge against medical advice (DAMA) are susceptible to life-threatening consequences. By understanding the factors associated with DAMA, healthcare centres can build strategies to assist patients to receive optimal medical care and prevent unfavourable outcome. The objective of this study was to determine the factors associated with DAMA from the Emergency Department (ED) of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This was a prospective unmatched case control study conducted over a 4-month period. For every DAMA episode, two patients who were admitted on the same day were randomly selected as control. Following patient consent, data was collected using a standardized questionnaire. Patients were contacted by the investigator for information regarding hospitalization within two weeks of DAMA. Ninety three patients were recruited; 31 DAMA patients and 62 admitted patients. Payment method was significantly associated with DAMA (OR 3.17 95% CI 1.29-7.98; p=0.01). The likelihood of self-paying patients to take DAMA was three times higher than those who had a guarantor letter from their employer or insurance provider. Other factors which influence DAMA were family obligations (OR 4.08 95% CI 1.09-15.26; p = 0.03) and work problems (OR 3.83 95% CI 1.13-12.94; p=0.03). A total of 19.4% of DAMA patients left following symptomatic pain relief. A total of 80.6% DAMA patients were admitted to hospital within two weeks of the DAMA episode. Payment method significantly influences DAMA. Payment planning, social welfare services, non-governmental organization funds and the introduction of a national health policy scheme may aid hospital payment, alleviate financial limitation of patients and reduce DAMA episodes.
format	Article
author	Ahmad Khaldun Ismail, Mohamad Ali S, Che’ Man Z,
spellingShingle	Ahmad Khaldun Ismail, Mohamad Ali S, Che’ Man Z, Factors associated with discharge against medical advice from Emergency Department, Universiti Kebangsaan Malaysia Medical Centre
author_facet	Ahmad Khaldun Ismail, Mohamad Ali S, Che’ Man Z,
author_sort	Ahmad Khaldun Ismail,
title	Factors associated with discharge against medical advice from Emergency Department, Universiti Kebangsaan Malaysia Medical Centre
title_short	Factors associated with discharge against medical advice from Emergency Department, Universiti Kebangsaan Malaysia Medical Centre
title_full	Factors associated with discharge against medical advice from Emergency Department, Universiti Kebangsaan Malaysia Medical Centre
title_fullStr	Factors associated with discharge against medical advice from Emergency Department, Universiti Kebangsaan Malaysia Medical Centre
title_full_unstemmed	Factors associated with discharge against medical advice from Emergency Department, Universiti Kebangsaan Malaysia Medical Centre
title_sort	factors associated with discharge against medical advice from emergency department, universiti kebangsaan malaysia medical centre
publisher	Fakulti Perubatan, UKM
publishDate	2016
url	http://journalarticle.ukm.my/9785/ http://journalarticle.ukm.my/9785/ http://journalarticle.ukm.my/9785/1/5._Ismail_et_al.pdf
first_indexed	2023-09-18T19:55:43Z
last_indexed	2023-09-18T19:55:43Z
_version_	1777406515409321984

Factors associated with discharge against medical advice from Emergency Department, Universiti Kebangsaan Malaysia Medical Centre

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