The Reasons for the Discharge against Medical Advice (DAMA) of Patients in Ghaem Research-Training and Medical Center of Mashhad in 2015

DAMA indicates the existence of serious problems in the quality of hospital services, which can exacerbate the disease and increase the risk of readmission to the hospital. In this study we examined Reasons for the DAMA of Patients in Ghaem hospital of Mashhad in 2015. In this cross-sectional, descriptive study, 6645 patients who had been discharged from Ghaem Hospital of Mashhad with their own personal desire in the first 9 months of 2015 were selected as the respondents. For data collection, the information contained in the health information system of the hospital and then the required information which was not available in this system were obtained via telephone call with respondents. The data were statistically analyzed descriptive statistics in SPSS-22. All patients admitted to Gheam Hospital of Mashhad in the first nine months of 2012 was equal to 53558, 6645 of whom (12.4%) were discharged with their own desire. About the reasons of DAMA, 13.1% of patients had called for DAMA for reasons related to the hospital and 86.7% of them had called for DAMA for reasons related to themselves. The main reasons for AMA were: patient- related reasons(The patient's personal and family reasons 41.8%) ¡hospital- related reason (Overcrowding of wards 6.6%)¡ Improved communication between physician and patient, patient’s increased awareness of probable complications of early discharge, improved quality of hospital services, using clinical aids and designing green space and a pleasant environment are the recommended strategies to reduce the rate of discharge against medical advice.