Discharge against medical advice from a Tehran emergency department
International Journal of Health Care Quality Assurance
ISSN: 0952-6862
Article publication date: 8 February 2016
Abstract
Purpose
The purpose of this paper is to identify the main reasons for discharge against medical advice (DAMA) in the emergency department (ED) of a teaching hospital in Tehran, Iran.
Design/methodology/approach
This cross-sectional study was conducted on all the patients who left the ED of a referral teaching hospital against medical advice (AMA) in 2008. A questionnaire was filled out for each patient to determine the reasons behind patient leaving AMA.
Findings
In total, 12.8 percent of the patients left the hospital AMA. Dissatisfaction with being observed in the ED, having a feeling of recovery and hospital personnel encouraging patients to leave the hospital were the main reasons for leaving the hospital AMA.
Practical implications
Like many other centers, the results showed that poor communication skill and work overload were the main contributing factors to DAMA. The center managed to improve patient satisfaction and thus lowered DAMA rates following this study. Considering the similarities reported in the reports and that of other studies, it could be concluded that policy makers in other centers can also benefit from the results to adopt effective approaches to reduce DAMA rate.
Originality/value
To the knowledge no study has evaluated the rate and the reasons behind DAMA in the Iranian EDs.
Keywords
Acknowledgements
This study is supported by grants from the Tehran University of Medical Sciences (Grant No. 8602305623). The authors acknowledge Fathi, ED head nurse and all ED personnel for their kind cooperation during the study. The authors are indebted to Sina Research Development Center for its kind support, Pourmand for language editing and Dr M. Aloosh for his valuable comments and editing the manuscript.
Citation
Hadadi, A., Khashayar, P., Karbakhsh, M. and Vasheghani Farahani, A. (2016), "Discharge against medical advice from a Tehran emergency department", International Journal of Health Care Quality Assurance, Vol. 29 No. 1, pp. 24-32. https://doi.org/10.1108/IJHCQA-03-2015-0030
Publisher
:Emerald Group Publishing Limited
Copyright © 2016, Emerald Group Publishing Limited