Irán
Introduction: Discharge against Medical Advice (AMA) is a process where the patient leaves the hospital, sooner than the stipulated time and before completing the course of treatment, which may indicate some problems in the hospital or the quality of provided healthcare. Hence, in this study, the causes of discharge against medical advice at Shahid Rasi Hospital of Shahindej have been studied.Methods: This descriptive-analytical cross-sectional study was conducted to assess the reasons of discharge against medical advice, among inpatients and outpatient patients of Shahid Rasi Hospital of Shahindej. Sampling was done by a systematic randomized method, and 111 patients discharged against medical advice were selected as sample, since 21 March 2017 to 21 June 2017. Data were collected using a questionnaire, which its validity and reliability was verified. The data were analyzed using SPSS 20, and the statistical tests, t-test and one way ANOVA at a significant level of P <0.05.Results: In this study, among 111 patients, 93 patients (83.8%) referred to the emergency department, 35 (31.5%) were male and 76 (68.5%) were women. The factor of patient-related reasons has the most score (18.75), and show that its higher impact on discharge against medical advice and hospital-related reasons has the lowest scores (9.26). Among the factors related to the patient, the most score related to the questions of enough satisfactory feeling and the willingness to continue home therapy at home is with the mean of 2.67, and frustration with the current condition and improvement of the disease with the mean of 1.97. Gender, education, and residence had a significant relationship with discharge against medical advice.
Conclusion: discharge against medical advice is associated with various factors, knowing these factors reduces side effects and re-costs, and conducting targeted counseling leads to reasonable decision-making from patient.