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Year : 2011  |  Volume : 14  |  Issue : 3  |  Page : 132-135

Discharge against medical advice: Factors and patients' characteristics in Abuth, Zaria

1 Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
2 Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Correspondence Address:
T Dahiru
Department of Community Medicine, ABU, Zaria
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Source of Support: None, Conflict of Interest: None

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Background: Discharge against medical advice presents ethical dilemma to the medical staff and reflects a failure to reach consensus between the medical personnel and the patient or his/her custodian regarding the need for continued in-patient care. It also presents a challenge for the medical staff in terms of counseling, quality of service as well as legal implications. To determine factors responsible for DAMA in ABUTH this study was conducted. Method: The study was an unmatched retrospective case-control in design involving all patients DAMA between 2005 and 2008. The controls are patients admitted 24 hours before and 24hours after the admission of patient ending up as DAMA; the controls were discharged formally by the attending physician. Relevant information of both DAMA and non-DAMA patients were extracted from their case notes by means of a proforma: age, sex, marital status, religion, occupation, residence, diagnosis and length of stay. The extracted data was entered and analyzed using SPSSv16. Results: There were a total of 21,725 admissions, 16,360 discharges and 2701 deaths during the study period. Of the 21,725 admissions 225 (1.37%) ended up as DAMA. Patient's characteristics that significantly determined DAMA are young age, male patient, admission through ER and a diagnosis of road traffic accident. Conclusion: Discharge against medical advice is prevalent in ABUTH and factors significantly influence DAMA include young age, male gender, admission through ER, involvement in road accident, surgical as well as OBGYdiagnoses.

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