Rate and Causes of Discharge against Medical Advice in Iranian Hospitals: A Systematic Review and Meta-Analysis.

Background: Discharge against Medical Advice (DAMA) is a problem for hospitals which may result in increasing readmissions, morbidities, inabilities, deaths and health care costs. This study, aimed to investigate the rate and causes of DAMA in Iranian hospitals. Methods: A systematic review and meta...

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Published in:Iranian Journal of Public Health Vol. 44; no. 7; pp. 902 - 913
Main Authors: MOHSENI, Mohammad, ALIKHANI, Mahtab, TOURANI, Sogand, AZAMI-AGHDASH, Saber, ROYANI, Sanaz, MORADI-JOO, Mohammad
Format: meta analysis research systematic review tables/charts Journal Article
Published: Tehran University of Medical Sciences Jul2015
Online Access:View this record in EBSCOhost
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      dt: Jul2015
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      pub: Tehran University of Medical Sciences
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        atl: Rate and Causes of Discharge against Medical Advice in Iranian Hospitals: A Systematic Review and Meta-Analysis.
      aug:
        au:
          MOHSENI, Mohammad
          ALIKHANI, Mahtab
          TOURANI, Sogand
          AZAMI-AGHDASH, Saber
          ROYANI, Sanaz
          MORADI-JOO, Mohammad
        affil: Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
      sug:
        subj:
          Patient Discharge Trends
          Patient Discharge Psychosocial Factors
          Hospitals
          Treatment Refusal
          Human
          Systematic Review
          Meta Analysis
          Iran
          PubMed
          Web Search Engines
          Embase
          Resource Databases, Health
          Data Analysis Software
          Male
          Female
          T-Tests
          P-Value
          Confidence Intervals
          Content Analysis
          Descriptive Statistics
          Sex Factors
          Male
          Female
      ab: Background: Discharge against Medical Advice (DAMA) is a problem for hospitals which may result in increasing readmissions, morbidities, inabilities, deaths and health care costs. This study, aimed to investigate the rate and causes of DAMA in Iranian hospitals. Methods: A systematic review and meta-analysis study was conducted in 2014. Required data were collected through searching for key words included: "Discharge Against Medical Advice", "Leaving against medical advice", "causes*", "hospital" and their Persian equivalents, over databases including PubMed, OVID, Google Scholar, Embase, Scopus, Magiran, scientific information database (SID). The reference lists of the articles, certain relevant journals and web sites in this field were also searched. Results: Out of 913 articles initially retrieved, finally 17 articles were incorporated into the study. There were 244858 individuals studied in the articles. Using a random effects model, the rate of DAMA in Iranian hospitals was estimated at 7.9% (6.3%-9.8%). While the highest rate of DAMA was associated with patients in departments of psychiatry (12%), the lowest rate was related to patients in departments of pediatrics (3.7). DAMA was in men more than women (P<0.05) Patient's perception of feeling of wellbeing, financial problems, family problems, the lack of attention from physicians and nurses, inappropriate behavior with patients by hospital team and the lack of timely care were mentioned as main causes for DAMA. Conclusion: The rate of DAMA in Iranian hospitals is relatively high. Thus effective initiatives in this area are required.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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