Discharge against medical advice from emergency department

• Autor(a) principal: Bernardete, Paula
• Data de Publicação: 2022
• Outros Autores: Cunha, Madalena, Vicente, Ana Rita, Mota, Mauro
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.56732/pensarenf.v25i2.186
• topic: Patient Discharge; Emergency Service Hospital; Quality Indicators; Health Care; Alta do Paciente; Serviço Hospitalar de Emergência; Indicadores de Qualidade em Assistência à Saúde

Introduction: The prevalence of discharge against medical advice from the emergency department is a clinical indicator of quality management and its study is therefore relevant.  The aim of this research was to assess the profile of clients leaving the emergency department. Methods: Quantitative Analysis and retrospective cohort study. All clients who left the emergency department of a central hospital in central Portugal in 2018 were included. The data was collected on the basis of administrative information, with registration on a specific clinical data collection table. Results: In 2018, 85596 patients came to the emergency service, with a abandonment rate of 3.04% (n=2599). Of the total sample, 1315 patients (50.6%) were male and 1284 (49.4%) female. The average age of customers is 48.21 years old and 46.4% are in the 36-65 age group. The months in which there were the most abandonment records were August (n=11.6%) and February (n=10.4%), and it was during the morning that there were the most abandonment episodes (51.3%). The patients with the clinical priority classified as urgent were those with the highest prevalence of abandonment (39.6%). The clinical priority of non-urgent patients shows 37.9% of abandonments. The majority of patients who left the emergency service after being evaluated by medical screening (78.7%). Conclusion: The profile of the patients leaving the emergency service is predominantly female, aged 35-65 (with an average age of 48.21), most of whom already have a defined clinical priority and are classified as urgent (yellow). The resolution of this problem should be assumed as a priority by the regulatory authorities, in order to optimize the quality of care and reduce the direct and indirect impact on patients who leave the services.