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Year : 2007  |  Volume : 10  |  Issue : 3  |  Page : 200-204

Discharge of hospitalized under-fives against medical advice in Benin City, Nigeria

Department of Child Health, College of Medical Sciences Universit of Benin Benin City, Nigeria

Correspondence Address:
A N Onyiriuka
Department of Child Health, College of Medical Sciences Universit of Benin Benin City, Nigeria

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Source of Support: None, Conflict of Interest: None

PMID: 18072444

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OBJECTIVE: To determine the incidence of discharge against medical advice (DAMA) among under-fives in Benin City, document reasons for these discharges and suggest ways of reducing its occurrence. METHODS: The admissions and discharges registers as well as the case-notes of all children aged between one and fifty-nine months admitted over a two-year period were retrospectively examined. The data obtained included sex, age, main diagnosis, signatories to the discharge documents and reasons/circumstances for DAMA. RESULTS: Of the 1017 under-fives admitted, 58 (5.7%) were DAMA with a higher prevalence in girls (7.4%) than in boys (4.2%) p>0.05. The incidence of DAMA (9.7%) was highest among children aged 24-35 months. About half (51.7%) of the parents of children DAMA either did not have formal education or failed to complete primary education. Thirty seven (63.8%) of parents of children DAMA belonged to social classes IV and V. The fathers were the signatories to the discharge documents in 65.5% and the mothers in only 5.2% of cases. Within 24-48 hours after DAMA, 20.7% of cases were re-admitted. Parental fear of accumulation of hospital bills was the commonest reason for DAMA. Mean duration of hospital stay was 3.1 days. CONCLUSION: Discharge of hospitalised under-fives against medical advice is a common social paediatric problem with gender differentials in its incidence. We believe that with improvement in the socio-economic status of our parents the incidence of DAMA will be greatly reduced.

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