Hong L E, Ling F C
Dept of Paediatrics, Alexandra Hospital.
J Singapore Paediatr Soc. 1992;34(1-2):34-8.
A retrospective study on discharges of children from hospital against medical advice or at own risk (AOR) discharges was conducted at our department from March 1981 to February 1990. There were altogether 890 patients giving an average incidence of 2%/year. The racial composition comprised 62.5% Chinese, 28.5% Malay, 7.3% Indian and 1.7% others. The common reasons for AOR discharge includes: (a) Inconvenience of having the child hospitalised (18.4%). (b) Preference of being treated by the general practitioner (15%). (c) Parents think child is well (14%). (d) Preference of being treated by private specialist or other hospital (11.9%) etc. Neonate comprised 16.9%, infants (except neonates) 44%, children > 1-5 yrs 28.6%, > 5-10 yrs 7.7% and > 10 yr 1.9%. The common diagnoses of these children include gastroenteritis (13.9%), febrile fit (13%), upper respiratory tract infection (11.7%), neonatal jaundice (5.7%). In conclusion AOR discharges of children from hospital is not uncommon and more could be done to reduce the incidence.
1981年3月至1990年2月，我们科室对儿童违反医嘱自行出院或自行承担风险出院（AOR出院）情况进行了一项回顾性研究。共有890例患者，平均年发生率为2%。种族构成包括62.5%的华人、28.5%的马来人、7.3%的印度人和1.7%的其他种族。AOR出院的常见原因包括：（a）孩子住院不便（18.4%）。（b） 倾向于由全科医生治疗（15%）。（c） 父母认为孩子已康复（14%）。（d） 倾向于由私立专科医生或其他医院治疗（11.9%）等。新生儿占16.9%，婴儿（不包括新生儿）占44%，1至5岁儿童占28.6%，5至10岁儿童占7.7%，10岁以上儿童占1.9%。这些儿童的常见诊断包括肠胃炎（13.9%）、热性惊厥（13%）、上呼吸道感染（11.7%）、新生儿黄疸（5.7%）。总之，儿童违反医嘱自行出院并不罕见，可采取更多措施降低发生率。
