Determinants of discharge against medical advice from a rural neurosurgical service in a developing country: A prospective observational study.

摘要: Background In low-resource regions of the world, discharge against medical advice (DAMA) is one empiric contributory factor to poor in-hospital outcome that not often mentioned. This study aims investigate determinants DAMA from a rural neurosurgical service in developing country. Methods was prospective observational all patients who discharged our between November 2018 and October 2019. Results There were 88 patients, 67 (76.1%) males, study, (M:F = 3.2:1), representing 17.4% patient population period. The peak incidence 20-29 years age group which accounted for 37.5% cases. About 55% presented directly center; 31.8% referred other hospitals, while 3.4% came traditional caregivers 1.1% religious homes. Head injury most common indication presentation (76.1% cases). duration hospital stay ranged 2 h 14 days. Majority (87.5%) left within 8 presentation. reason financial constraints 50% cases, inadequate health literacy 20.5%, together 12.5%, misgivings 4.5%, belief 2.3%. Neurotrauma predictive early (P 0.001). Conclusion rate high study. Financial with socioeconomic limitations causes environment.