Analysis of Reasons for Orthopaedic Walkouts from the Emergency Department in a Private Tertiary Care Centre
| Autor: | G M Sharma, F Wadia, K D Roy, F Qureshi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Developing country Tertiary care 03 medical and health sciences 0302 clinical medicine discharge cost medicine Orthopedics and Sports Medicine Original Study 030212 general & internal medicine Orthopedic surgery business.industry Against medical advice 030208 emergency & critical care medicine Emergency department developing countries DAMA medicine.disease orthopaedic Structured interview Emergency Medicine Surgery Medical emergency business RD701-811 Patient education Insurance coverage |
| Zdroj: | Malaysian Orthopaedic Journal Malaysian Orthopaedic Journal, Vol 14, Iss 3, Pp 137-142 (2020) |
| ISSN: | 2232-111X 1985-2533 |
| Popis: | INTRODUCTION: A small proportion of patients presenting to the Emergency department (ED) of any hospital tend to take discharge against medical advice (DAMA) due to several patient related or hospital/service related reasons. Amongst these, orthopaedic patients are a special group due to their inability to mobilise independently due to injuries and have treatment needs which involve higher costs. The aim of the current study was to ascertain and analyse the reasons for orthopaedic walkouts at a tertiary care new private hospital. MATERIALS AND METHODS: This retrospective telephonic structured interview-based study was carried out on all orthopaedic patients taking DAMA during a one-year period from July 2016 to June 2017. They were telephonically interviewed with a structured questionnaire. Hospital and ED records were analysed for demographic as well as temporal characteristics. RESULTS: A total of 68 orthopaedic patients walked out of casualty against medical advice out of a total 775 (8.77%) orthopaedic patients presenting during the period as against 6.4% overall rate of DAMA for all specialties. The main reasons for DAMA were financial unaffordability of treatment (36.7%), preference for another orthopaedic surgeon (22%) and on advice of the patient’s General Practitioner (16.1%). CONCLUSION: Unaffordability of treatment is a significant cause for walkouts amongst orthopaedic patients. Private hospitals need to recognise and implement processes by which these patients can be treated at affordable costs and with coverage either by medical insurance or robust charity programs. Patient education and awareness are important to encourage them to have insurance coverage. |
| Databáze: | OpenAIRE |
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