Patients who leave the emergency department against medical advice
Clinical and Experimental Emergency Medicine
;
(4): 88-94, 2016.
Artigo
em Inglês
| WPRIM
| ID: wpr-648409
ABSTRACT
OBJECTIVE:
Discharge against medical advice (DAMA) from the emergency department (ED) accounts for 0.1% to 2.7% of all ED discharges. DAMA carries a risk of increased mortality and readmissions. Our aim was to investigate the general characteristics of DAMA patients and the differences between them and non-DAMA patients.METHODS:
We reviewed data collected by the National Emergency Medical Center between 2010 and 2011. Subjects were categorized into 2 groups, namely, the DAMA group and the non-DAMA group. We compared these groups with respect to age, gender, trauma or non-trauma status, type of hospital, health insurance, level of consciousness on admission, and diagnosis.RESULTS:
Of 8,000,529 patients, 222,389 (2.78%) left against medical advice. The risk factors for DAMA across all age groups were as follows no medical insurance (odds ratio [OR], 1.993), initial response to voice (OR, 2.753) or pain (OR, 2.101), trauma admission (OR, 1.126), admission to a local emergency medical center (OR, 1.215), and increased age. A high risk of DAMA was observed among patients with immune, endocrine, psychiatric, neurological, circulatory diseases, and external causes of morbidity and mortality.CONCLUSION:
Although DAMA cases account for only a small percentage of hospital discharges, they are important because DAMA patients have high readmission and mortality rates. It is therefore important to understand the general characteristics and predictors of DAMA in order to improve patient outcome and minimize the economic burden on the healthcare system.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Organização e Administração
/
Alta do Paciente
/
Voz
/
Fatores de Risco
/
Mortalidade
/
Estado de Consciência
/
Atenção à Saúde
/
Diagnóstico
/
Emergências
/
Serviço Hospitalar de Emergência
Tipo de estudo:
Estudo diagnóstico
/
Estudo de etiologia
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
Idioma:
Inglês
Revista:
Clinical and Experimental Emergency Medicine
Ano de publicação:
2016
Tipo de documento:
Artigo
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