Background: Discharge Against Medical Advice (DAMA) occurs
when a patient leaves the hospital contrary to the managing physician's
recommendation. DAMA, with its attendant effects of increased healthcare cost
and mortality, is common globally. Therefore, DAMA must be continuously brought
into public discourse, and strategies to address it should be explored.
Aim: The aim of this study was to highlight the Patterns of
injuries by Road Traffic Accident victims, the implications of discharge
against Medical Advice on certain critical injuries, and the importance of
follow-up.
Methods: A retrospective study was carried out at the
Federal Medical Centre Makurdi, a tertiary health facility in North Central
Nigeria, from January 2021 to March 2022. Medical records (case notes) of 121
patients who were involved in Road Traffic Accidents (RTAs), and were admitted
either into the ward through the Accident and Emergency Unit, or at the
Accident and Emergency Unit of the hospital, were retrieved and analyzed
against such variables as age, sex, occupation, resident, types of injury, and
length of hospital stay. Descriptive
Statistics were deployed using Microsoft Excel and Statistical Package for
Social Sciences (SPSS) to analyse the data.
Results: DAMA rate was 12.4% (n=15), of which 8 (6.6%) were
females, and 7 (5.7%) were males. Head injury was the commonest injury, 8
(53.3%), seen, while musculoskeletal injuries were 7 (46.7%). The majority of
the victims, 6, were in the age group, 30-39 years, with an average age of
37.2. Farmers and housewives were the dominant occupational groups involved.
The average hospital stay was 6 days. There was no form of health insurance
coverage or follow-up protocol.
Conclusion: DAMA for critically injured patients is common
in our environment, and there is no known established follow-up system. There
is no health insurance coverage. Physicians must strive to track and follow up
on these patients to improve outcomes.
Author(s) Details
Suega P. Inunduh
Department of Human Anatomy/Surgery, Veritas University Abuja, Nigeria.
Anthony A. Amuta
Department of Surgery, Federal Centre Makurdi, Nigeria.
Please see the book here :- https://doi.org/10.9734/bpi/msup/v3/6808
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