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Mohseni M, Alikhani M, Tourani S, et al. Rate and Causes of Discharge against Medical Advice in Iranian Hospitals: A Systematic Review and Meta-Analysis. Iran J Public Health. 2015;44(7):902-12
Mohseni, M., Alikhani, M., Tourani, S., Azami-Aghdash, S., Royani, S., & Moradi-Joo, M. (2015). Rate and Causes of Discharge against Medical Advice in Iranian Hospitals: A Systematic Review and Meta-Analysis. Iranian journal of public health, 44(7), 902-12.
Mohseni, Mohammad, et al. "Rate and Causes of Discharge against Medical Advice in Iranian Hospitals: A Systematic Review and Meta-Analysis." Iranian journal of public health vol. 44,7 (2015): 902-12.
Mohseni M, Alikhani M, Tourani S, Azami-Aghdash S, Royani S, Moradi-Joo M. Rate and Causes of Discharge against Medical Advice in Iranian Hospitals: A Systematic Review and Meta-Analysis. Iran J Public Health. 2015 Jul;44(7):902-12. PMID: 26576368; PMCID: PMC4645761.
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Iran J Public Health. 2015 Jul;44(7):902-12.

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

Iranian journal of public health

Mohammad Mohseni, Mahtab Alikhani, Sogand Tourani, Saber Azami-Aghdash, Sanaz Royani, Mohammad Moradi-Joo

Affiliations

  1. Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
  2. School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
  3. Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran.
  4. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

PMID: 26576368 PMCID: PMC4645761

Abstract

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.

Keywords: Causes; Discharge; Iran; Meta-analysis; Rate; Systematic review

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