A Cross Sectional Study of Discharge Against Medical Advice Cases at a Tertiary Care Hospital of Central Gujarat Region

Background: Discharge Against Medical Advice (DAMA) is an obnoxious reality and dissatisfying event to both ends - patient and healthcare provider. It’s pertinent that periodical survey at single or multicentre be done to identify the predictors and seek solutions and suggest recommendations. Aim and Objectives: Aim of this study was to analyze the predictors of DAMA cases. Objectives were to find out prevalence and predictors of DAMA cases. Methodology: A prospective cross sectional analytical study was done at a tertiary level multi super speciality hospital of central Gujarat. Participants were all those cases who seek DAMA for one other attribute and consented to participate in the study by non-randomised method. After consent, details from DAMA cases were collected in pre-validated questionnaire forms from patients and relatives. All data was analysed statistically for descriptive and analytical statistics. Observations: Maximum DAMA cases were of age group 20-59 years (55%). followed by 60-100 years (25%). Most common reason for obtaining DAMA (56%) was financial constraints. Most of DAMA patients who were having financial constraints (70 & 46) were admitted to Medical Intensive Care Unit (33.11%) and Male Medicine ward (21.22%) respectively. Conclusion: DAMA cases are damaging not only patient morbidity and mortality wise, but also burdens healthcare staff and resources negatively. The reasons for DAMA cases should be discussed and analysed at every healthcare facilities regularly to prevent this futile dissatisfying event.