Albayati Asseel, Douedi Steven, Alshami Abbas, Hossain Mohammad A, Sen Shuvendu, Buccellato Vito, Cutroneo Anamarrie, Beelitz Jason, Asif Arif
Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ 07753, USA.
Healthcare (Basel). 2021 Jan 21;9(2):111. doi: 10.3390/healthcare9020111.
A patient decides to leave the hospital against medical advice. Is this an erratic eccentric behavior of the patient, or a gap in the quality of care provided by the hospital? With a significant and increasing prevalence of up to 1-2% of all hospital admissions, leaving against medical advice affects both the patient and the healthcare provider. We hereby explore this persistent problem in the healthcare system. We searched Medline and PubMed within the last 10 years, using the keywords "discharge against medical advice," "DAMA," "leave against medical advice," and "AMA." We retrospectively reviewed 49 articles in our project. Ishikawa fishbone root cause analysis (RCA) was employed to explore reasons for leaving against medical advice (AMA). This report presents the results of the RCA and highlights the consequences of discharge against medical advice (DAMA). In addition, the article explores preventive strategies, as well as interventions to ameliorate leaving AMA.
一名患者决定不听从医嘱擅自离院。这是患者反复无常、古怪异常的行为，还是医院提供的护理质量存在缺陷？在所有住院患者中，擅自离院的发生率高达1%-2%，且呈显著上升趋势，这对患者和医疗服务提供者都会产生影响。在此，我们探讨医疗系统中这一长期存在的问题。我们在过去10年里检索了Medline和PubMed，使用的关键词有“不听从医嘱出院”“擅自离院”“不听从医嘱离开”以及“擅自离院”。我们对项目中的49篇文章进行了回顾性分析。采用石川鱼骨图根本原因分析法（RCA）来探究不听从医嘱离开（AMA）的原因。本报告呈现了根本原因分析的结果，并突出了不听从医嘱出院（DAMA）的后果。此外，本文还探讨了预防策略以及改善擅自离院情况的干预措施。
