Factors Affecting Discharges against Medical Advice in an Emergency Department of a Tertiary Care Center

Authors

  • Trishna Shrestha KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal
  • Sneha Pradhananga KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal
  • Kabita Hada Batajoo KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal
  • Manjita Bajracharya KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal

DOI:

https://doi.org/10.3126/jkistmc.v2i2.33576

Keywords:

Discharge, Against Medical Advice, Emergency Department

Abstract

Introduction: Patients leaving against the advice of the treating team before being certified as fit is a major concern and challenge for the treating professionals as it possesses adverse medical outcomes. This study hence aimed at identifying the prevalence and major factors affecting such discharges so that advocacy can be done to help prevent it.

Methods: A descriptive cross-sectional study was conducted at emergency department of a tertiary center in Lalitpur from 15th May 2019 to 15th August 2019. All the patients visiting the emergency department were included in the study and a non-probability purposive sampling method was used excluding the patients who denied giving reasons for them leaving against medical advice. Data was collected using pre-structured questionnaire and analyzed using SPSS-v21 software.

Results: A hundred and fifteen patients (4.08%) left against medical advice out of 2812 patients who presented to emergency department. There were 63 male patients (54.8%), 75 patients of the total patients in the age group of 15-44 years (65.2%) and those living within a distance of 1km from the hospital (53%). The most common reason for the patients leaving against medical advice was found to be due to financial constraint (38.3%) followed by preference to other hospitals (16.5%).

Conclusion: Patients leaving against medical advice possesses a small percentage of actual hospital admissions but is still a major health concern as it drastically increases the morbidity, re-admission rates and total health-care costs. Hence, understanding the general characteristics and predictors of such discharges is of utmost importance to help improve the patient outcome and reduce the health-care costs.  

Downloads

Download data is not yet available.
Abstract
25
PDF
19

Author Biographies

Trishna Shrestha, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal

Lecturer, Department of Family Medicine and Emergency Medicine

Sneha Pradhananga, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal

Department of Family Medicine and Emergency Medicine

Kabita Hada Batajoo, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal

Department of Family Medicine and Emergency Medicine

Manjita Bajracharya, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal

Department of Family Medicine and Emergency Medicine

Downloads

Published

2020-07-31

How to Cite

Shrestha, T., Pradhananga, S., Batajoo, K. H., & Bajracharya, M. (2020). Factors Affecting Discharges against Medical Advice in an Emergency Department of a Tertiary Care Center. Journal of KIST Medical College, 2(2), 31–35. https://doi.org/10.3126/jkistmc.v2i2.33576

Issue

Section

Articles