Analysis of Reasons for Orthopaedic Walkouts from the Emergency Department in a Private Tertiary Care Centre
https://doi.org/10.5704/MOJ.2011.021
- Author:
Roy KD
1
;
Sharma GM
2
;
Qureshi F
3
;
Wadia F
4
Author Information
1. Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, United Kingdom
2. Department of Orthopaedics, MGM Medical College Kamothe, Kamothe, India
3. Department of Trauma and Orthopaedics, Barnsley Hospital NHS Foundation Trust, Barnsley, United Kingdom
4. Department of Orthopaedics, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, India
- Publication Type:Journal Article
- Keywords:
orthopaedic, discharge, DAMA, developing countries, cost
- From:Malaysian Orthopaedic Journal
2020;14(No.3):137-142
- CountryMalaysia
- Language:English
-
Abstract:
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.
- Full text:16.2020my1122.pdf
