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Discharge against Medical Advice among Inpatients with Heart Disease in Iran
BACKGROUND: Discharge against medical advice (DAMA) is a relatively common problem worldwide. We sought to determine the prevalence of and reasons for DAMA among inpatients of our cardiac center. METHODS: From a total of 20289 discharges from our cardiac teaching hospital, 992 (4.9%) patients at a m...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Tehran University of Medical Sciences
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466903/ https://www.ncbi.nlm.nih.gov/pubmed/23074641 |
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author | Manouchehri, Jila Goodarzynejad, Hamidreza Khoshgoftar, Zohreh Sheikh Fathollahi, Mahmood Aghamohammadi Abyaneh, Maryam |
author_facet | Manouchehri, Jila Goodarzynejad, Hamidreza Khoshgoftar, Zohreh Sheikh Fathollahi, Mahmood Aghamohammadi Abyaneh, Maryam |
author_sort | Manouchehri, Jila |
collection | PubMed |
description | BACKGROUND: Discharge against medical advice (DAMA) is a relatively common problem worldwide. We sought to determine the prevalence of and reasons for DAMA among inpatients of our cardiac center. METHODS: From a total of 20289 discharges from our cardiac teaching hospital, 992 (4.9%) patients at a minimum age of 18 years were cases of DAMA. After excluding 49 cases due to missing data, we retrospectively analyzed our prospectively collected data from 943 patients, who were DAMA cases. Patients’ characteristics, including demographic details, reason for discharge, insurance status, and length of stay before discharge, were examined. RESULTS: The mean age of the study patients was 60.7 ± 13.0 (range, 18–94 years) with a male-to-female ratio of 2.1/1. Lack of consent to surgery or other invasive procedures was the reason cited for DAMA in 31% of the patients, followed by personal or family issues (17%). No reason for DAMA was reported in 26 (2.8%) of the patients. Women compared to men were more likely to cite “lack of consent to surgery or invasive procedures” as the reason for DAMA (p value = 0.005), whereas men more prevalently stated “personal or family issues” as the reason for DAMA (18.7% vs. 12.7%, p value = 0.022). CONCLUSION: The most frequent self-reported reason for DAMA in our cardiac patients was lack of consent to surgery or invasive procedures. This may be because of fear of undergoing invasive procedures such as revascularization. Explaining the stages of a given invasive procedure to patients and comparing its risks versus benefits may lessen impulsive decision-making and DAMA. |
format | Online Article Text |
id | pubmed-3466903 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Tehran University of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-34669032012-10-16 Discharge against Medical Advice among Inpatients with Heart Disease in Iran Manouchehri, Jila Goodarzynejad, Hamidreza Khoshgoftar, Zohreh Sheikh Fathollahi, Mahmood Aghamohammadi Abyaneh, Maryam J Tehran Heart Cent Original Article BACKGROUND: Discharge against medical advice (DAMA) is a relatively common problem worldwide. We sought to determine the prevalence of and reasons for DAMA among inpatients of our cardiac center. METHODS: From a total of 20289 discharges from our cardiac teaching hospital, 992 (4.9%) patients at a minimum age of 18 years were cases of DAMA. After excluding 49 cases due to missing data, we retrospectively analyzed our prospectively collected data from 943 patients, who were DAMA cases. Patients’ characteristics, including demographic details, reason for discharge, insurance status, and length of stay before discharge, were examined. RESULTS: The mean age of the study patients was 60.7 ± 13.0 (range, 18–94 years) with a male-to-female ratio of 2.1/1. Lack of consent to surgery or other invasive procedures was the reason cited for DAMA in 31% of the patients, followed by personal or family issues (17%). No reason for DAMA was reported in 26 (2.8%) of the patients. Women compared to men were more likely to cite “lack of consent to surgery or invasive procedures” as the reason for DAMA (p value = 0.005), whereas men more prevalently stated “personal or family issues” as the reason for DAMA (18.7% vs. 12.7%, p value = 0.022). CONCLUSION: The most frequent self-reported reason for DAMA in our cardiac patients was lack of consent to surgery or invasive procedures. This may be because of fear of undergoing invasive procedures such as revascularization. Explaining the stages of a given invasive procedure to patients and comparing its risks versus benefits may lessen impulsive decision-making and DAMA. Tehran University of Medical Sciences 2012 2012-05-31 /pmc/articles/PMC3466903/ /pubmed/23074641 Text en Copyright © Tehran Heart Center, Tehran University of Medical Sciences http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly. |
spellingShingle | Original Article Manouchehri, Jila Goodarzynejad, Hamidreza Khoshgoftar, Zohreh Sheikh Fathollahi, Mahmood Aghamohammadi Abyaneh, Maryam Discharge against Medical Advice among Inpatients with Heart Disease in Iran |
title | Discharge against Medical Advice among Inpatients with Heart Disease in Iran |
title_full | Discharge against Medical Advice among Inpatients with Heart Disease in Iran |
title_fullStr | Discharge against Medical Advice among Inpatients with Heart Disease in Iran |
title_full_unstemmed | Discharge against Medical Advice among Inpatients with Heart Disease in Iran |
title_short | Discharge against Medical Advice among Inpatients with Heart Disease in Iran |
title_sort | discharge against medical advice among inpatients with heart disease in iran |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466903/ https://www.ncbi.nlm.nih.gov/pubmed/23074641 |
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