J Anal Res Clin Med. 2016;4(2):90-96.
doi: 10.15171/jarcm.2016.015
  Abstract View: 783
  PDF Download: 471

Original Article

Frequency and causes of discharges against medical advice from hospital cardiac care units of East Azerbaijan, Iran

Saber Azami-Aghdash 1, Hassan Abolghasem Gorji 2, Mohammad Moradi-joo 3, Hassan Almas pour 4, Sanaz Royani 5 *

1 PhD Candidate, Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2 Associate Professor, Health Management and Economics Research Center AND Center of Excellence in Health Management and Economics, Iran University of Medical Sciences, Tehran, Iran
3 MSc Student, Department of Health Management, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
4 MSc Student, Department of Midwifery, Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
5 PhD Candidate, School of Health Management and Information Sciences , Iran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: Discharges against medical advice (DAMA) is a common problem of hospitals that could lead increasing the complications and readmission. For this, the aim of this study is to investigate the frequency and effective factors of DAMA in patients with cardiovascular disease in hospital cardiac care units (CCU) of East Azerbaijan, Iran. Methods: This cross-sectional study was performed, in 2013, in Tabriz University of Medical Sciences, Iran. Required information was extracted using valid and reliable forms of medical records of 2000 patients admitted to 20 CCU in 17 hospitals of East Azerbaijan, by two trained interviewers. Data analysis was performed using descriptive statistics (frequency, mean, percentage, etc.), chi-square test, and linear regression model using the SPSS software. The tests were considered a statistically significant level of 0.05%. Results: The results showed that 272 patients (13.6%) were DAMA from the hospital. The frequency of DAMA was in men more than women. The most frequency of discharge has occurred in the range of 40-80 years old. Results of linear regression showed that there was a significant correlation between DAMA and type of insurance, history of myocardial infarction (MI), comorbid disease, cause of hospitalization, location of hospital, and staying < 48 hours (P < 0.050). Conclusion: In this study, the rate of DAMA was relatively high compared with similar studies and it is considered as a concern problem that should study the reasons and its effective factors and plan effective interventions to reduce them.
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Submitted: 02 Nov 2015
Accepted: 24 Feb 2016
First published online: 09 May 2016
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