Related Experiment Videos
Discharges of children from hospital against medical advice
Insights
Discharges against medical advice (AOR) in children are common, occurring in 2% of cases annually. Key reasons include parental inconvenience and preference for general practitioners or private care.
Area of Science:
- Pediatrics
- Hospital Administration
- Public Health
Background:
- Discharges against medical advice (AOR) represent a significant challenge in pediatric care.
- Understanding the trends and reasons for AOR discharges is crucial for improving patient outcomes and healthcare resource management.
Purpose of the Study:
- To analyze the incidence, demographics, diagnoses, and reasons for AOR discharges in children over a ten-year period.
- To identify factors contributing to AOR discharges to inform strategies for reduction.
Main Methods:
- A retrospective study design was employed.
- Data were collected on 890 pediatric patients discharged against medical advice from March 1981 to February 1990.
- Analysis included patient demographics, diagnoses, and documented reasons for AOR discharge.
Main Results:
- The average annual incidence of AOR discharges was 2%, involving 890 patients.
- Common reasons cited were parental inconvenience (18.4%), preference for general practitioners (15%), and belief that the child was well (14%).
- Gastroenteritis, febrile seizures, and upper respiratory tract infections were frequent diagnoses among these children.
Conclusions:
- Pediatric AOR discharges are a notable occurrence, necessitating targeted interventions.
- Addressing parental concerns and improving communication can potentially reduce AOR discharge rates.
Abstract:
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.