Pediatric discharge against medical advice

Abstract

Purpose The purpose of this paper is to identify the reasons for discharges against medical advice (DAMA) and the possible outcomes among pediatric patients. Design/methodology/approach A retrospective cohort study was conducted on all children admitted and then discharged against medical advice in two maternity and children’s hospitals in Jeddah, 2014. Phone interviews were conducted, and medical records were reviewed for DAMA and control groups; a semi-structured questionnaire was used to collect this information. Findings The top three reasons identified for DAMA were parent’s false assumption that their child’s condition had improved (43.8 percent), dissatisfaction with treating/managing team (16.2 percent) and difficulties arranging care for patient’s siblings at home (7.7 percent). The readmission rate was significantly higher among DAMA pediatric patients compared to the control group (28.5 percent vs 11.5 percent) at 30-day follow-up, which highlights the importance for developing interventions aimed at reducing DAMA. Originality/value This study helps us to better understand DAMA reasons and outcomes. Understanding these factors can encourage appropriate interventions and policies for reducing DAMA rates. In this way, pediatric patients can be protected from inappropriate discharge consequences.