DISCHARGE AGAINST MEDICAL ADVICE AT CONNAUGHT HOSPITAL, FREETOWN, SIERRA LEONE (A PILOT SURVEY)

DISCHARGE AGAINST MEDICAL ADVICE IN FREETOWN

Abstract

BACKGROUND

Discharge against medical advice (DAMA) is the withdrawal of the consent given by a patient to medical personnel to offer his/her services. It is a critical problem in the hospitalization of patients in which a patient despite medical advice leaves the hospital earlier than due time.

Methodology

The study was conducted at the Connaught Hospital, University of Sierra Leone Teaching Hospital Complex. The study was designed as the pilot phase of a much bigger study on this issue which is of grave concern. The study population included patients admitted to the medical wards of Connaught Hospital. The present research was a descriptive, cross-sectional study conducted over a period of six weeks from 16th December 2019 to 31st January 2020. Data analysis was done using Statistical Package For Social Sciences Software (SPSS), version 20.

Results

A DAMA rate of 57% was obtained in this study. There is a male preponderance among DAMA patients, a vast majority of patients were < 40 years and were mostly students, traders or unemployed. The major reasons for DAMA were financial constraints, social reasons and reverting to herbal or alternative medicine. Most of the patients went back home or travelled to their villages. In the vast majority of cases, the decision was made by the patients themselves or their siblings or parents. The scenario where the decision to leave the hospital was made by others, was commoner with females than males and the difference was statistically significant (P< 0.05).

 Conclusion

There is a high DAMA rate in our hospital and the prevalent characteristics of such patients were younger age, male sex, traders or unemployed. The commonest reason for discharging against medical advice was financial constraints.