A QUALITATIVE STUDY TO ASSESS THE DETERMINANTS OF PATIENTS TAKING DISCHARGE AGAINST MEDICAL ADVICE (DAMA) IN TERTIARY CARE HOSPITAL.

Dr. Dhananjay Kumar Singh; Dr. Sandeep Mishra

Volume : VIII, Issue : IV, April - 2019

A QUALITATIVE STUDY TO ASSESS THE DETERMINANTS OF PATIENTS TAKING DISCHARGE AGAINST MEDICAL ADVICE (DAMA) IN TERTIARY CARE HOSPITAL.

Dr. Dhananjay Kumar Singh, Dr. Sandeep Mishra

Abstract :

Background: Leaving hospital against the physician�s advice may expose patients to the risk of their medical problem going inadequately treated. Research has shown that such patients are at higher risk of adverse health outcomes in terms of both morbidity and mortality. Objectives: 1. To study the proportion of patients taking Discharge Against Medical Advice (DAMA) compared to total patient discharges in the study unit 2. To study the socio demographic profile of the patients taking Discharge Against Medical Advice (DAMA) 3. To assess the determinants influencing occurrence of DAMA discharges 4. To assess the diagnosis of patients taking Discharge Against Medical Advice (DAMA) Methodology: Hospital based cross–sectional study. Methods & Materials: Data was collected through pretested semi–structured self –administered questionnaire by the investigators. Data collected were analyzed using statistical package for social sciences (SPSS) 21.0 software. Results & Conclusions: Overall, of which 42% reported leaving because of financial restrictions, 20% percent respondents indicated overcrowding in wards followed by 17.5% taken discharge because of poor behavior of medical staff. Females (62%) were more likely taken DAMA for financial reasons compared to males .28% taken DAMA because of subjective feeling of improvement in health. Among total patients 20.5% study subjects were coming outside from the metropolitan city. Among females who signed out DAMA, the decision was never made by the female herself