Self-discharge against medical advice from tertiary health institution: A call for concern

Niger Postgrad Med J. 2017 Jul-Sep;24(3):174-177. doi: 10.4103/npmj.npmj_88_17.

Abstract

Background: Self-discharge by patients without completing their treatment is a problematic issue in healthcare and is strongly associated with readmission and poor treatment outcome.

Patients and methods: A descriptive study of the rate and reasons why patients with limb injuries took self-discharge against medical advice (DAMA) from our facility, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria, a tertiary health institution between May 2011 and April 2014.

Results: One hundred and thirty-one (16.2%) patients took DAMA out of 810 patients seen with limb injuries. Age ranges from 3 to 95 years with a mean of 36.31 ± 19.34 years. Road traffic crash accounted for 110 (84%) of the injuries. One hundred and sixteen (88.5%) had fractures and 9 (6.9%) had soft tissue injuries. Fifty-eight (44.3%) of the patients were referred cases, 128 (97.7%) signed DAMA form while 3 (2.3%) absconded from the hospital. Reasons for DAMA were mainly; belief more in traditional bone setters (TBSs) (36.6%); pressure from relations (22.9%) and high cost of hospital care (19.8%). One hundred and one (77.1%) of the patients volunteered that they were going to TBS for continued care.

Conclusion: High percentage of patients DAMA from our facility and majority of them were in favour of unorthodox form of treatment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Hospitals, Teaching
  • Hospitals, University
  • Humans
  • Middle Aged
  • Nigeria
  • Patient Discharge*
  • Treatment Refusal*
  • Young Adult