Discharge Against Medical Advice (DAMA) in Adult Emergency Department of a Tertiary Hospital in Nigeria

West Afr J Med. | 2021 Dec 30;Vol. 38(12): |1058-1064

Abstract

Background: Patients who discharge against medical advice are at increased risk of morbidity and mortality as well as posing a serious burden for the hospital especially when re-admitted.

Aim: To determine the demographics, prevalence, clinical diagnosis and reasons for discharge against medical advice adult Emergency Department.

Methods: This was a retrospective descriptive study, carried out over one year period from June 2018 to May 2019 at University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. Patients who requested for Discharge Against Medical Advice (DAMA) were asked to fill a data collection form after adequate counselling. Data analysis was carried out using IBM SPSS version 21.

Results: A total of 476 patients signed the DAMA form. There was male predominance with a male to female ratio of 1.4: 1. The average age of the patients was 42 ± 21 years. Surgical diagnosis accounted for 287 (60.3%) cases while the rest were medical. The most common reasons for DAMA were "To go closer home and financial constraint".

Conclusion: Discharge against medical advice was more prevalent among male patients with surgical cases accounting for more than half of the cases. Financial constraints and going home were the two common reasons for DAMA.

Keywords: Adult Emergency Department; Clinical diagnosis andReasons for DAMA; DAMA; Demographic features; Prevalence.