Discussion forum Week 14: Discharge Against Medical Advice (DAMA) – DAMA refers to a situation where patients abandon treatment and leave hospitals against the will of doctors or medical staff…
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Discussion forum Week 14: Discharge Against Medical Advice (DAMA)
Solution
Discharge Against Medical Advice (DAMA)
DAMA refers to a situation where patients abandon treatment and leave hospitals against the will of doctors or medical staff. It is a perennial occurrence associated with many adverse effects (Zhu & Wu, 2019). In the context of the patient admitted for asthma treatment, the hospital’s managing director and staff must encourage the patient to stay for the therapy and steroid treatment.
This is because the decision will likely jeopardize the patient’s treatment progress, affecting the hospital’s operations and staff. Despite the need to respect the patient’s autonomy, the staff should help the patient understand the consequences of signing out of the AMA.
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Zhu and Wu (2019) observe that the hospital can be penalized for allowing AMA. For example, the affordable care act contains regulations penalizing hospitals for readmission within 30 days after discharge- under the hospital readmissions reduction program (HRRP). It can also lead to hospital congestion and stunted progress in patient care, whereby nurses are forced to repeat similar that could have been avoided.
Also, signing out AMA poses risks to the MD, such as ethical and legal issues like malpractice and poor treatment outcomes, which can negatively affect their reputation. Finally, Albayati et al. (2021) explain that the decision poses various risks to the patient, such as rehospitalization, which is associated with increased hospital costs.
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References
- Albayati, A., Douedi, S., Alshami, A., Hossain, M. A., Sen, S., Buccellato, V., … & Asif, A. (2021, January). Why do patients leave against medical advice? Reasons, consequences, prevention, and interventions. In Healthcare (Vol. 9, No. 2, p. 111). MDPI. DOI: https://doi.org/10.3390/healthcare9020111
- Zhu, H., & Wu, L. T. (2019). Discharge against medical advice from hospitalizations for substance use disorders: The potential impact of the Affordable Care Act. Drug and alcohol dependence, 197, 115-119.DOI: https://doi.org/10.1016/j.drugalcdep.2018.12.032
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