Prevalence, Predictors, and Reasons for Discharge against Medical Advice
(DAMA) among Patients with Chronic Disease during COVID-19
Abstract
Background. Discharge against medical advice (DAMA) is used in
healthcare facilities in a situation where patients refuse care or
decide to leave the hospital before the treating physician recommends
discharge. Previous studies have found DAMA to be prevalent among
patients with various chronic conditions. The study had four objectives.
The study aimed to investigate: 1) the prevalence of DAMA during
COVID-19 (2020-2021) among Jordanian patients with chronic diseases, 2)
the association between DAMA and sociodemographic and clinical
characteristics of patients with chronic diseases, 3) the predictors of
DAMA, and 4) the reasons behind DAMA at the patient, hospital, and
environmental levels. Methods. A descriptive cross-sectional
correlational design was used in the study. A convenience sampling
approach was used to collect data from 1576 patients with chronic
diseases from 3 private hospitals. Results. The study found
that the prevalence rate of DAMA was 33.3%. There was a significant
association between the sociodemographic and clinical characteristics of
patients with chronic diseases and DAMA. Health insurance found to be
the strongest predictor of DAMA. Finally, the study found that patient,
hospital, and environmental- related factors had a low impact on DAMA.
Conclusions: DAMA is prevalent among patients with chronic
diseases in Jordan during COVID-19 pandemic. The current study’s
findings can serve as an empirical basis for planning and implementing
DAMA prevention programs and/or establishing or revising policies for
the target population.