Prevalence, Predictors, and Reasons for Discharge against Medical Advice (DAMA) among Patients with Chronic Disease during COVID-19

Background. Discharge against medical advice (DAMA) is used in healthcare facilities in a situation where patients refuse care or decide to leave the hospital before the treating physician recommends discharge. Previous studies have found DAMA to be prevalent among patients with various chronic conditions. The study had four objectives. The study aimed to investigate: 1) the prevalence of DAMA during COVID-19 (2020-2021) among Jordanian patients with chronic diseases, 2) the association between DAMA and sociodemographic and clinical characteristics of patients with chronic diseases, 3) the predictors of DAMA, and 4) the reasons behind DAMA at the patient, hospital, and environmental levels. Methods. A descriptive cross-sectional correlational design was used in the study. A convenience sampling approach was used to collect data from 1576 patients with chronic diseases from 3 private hospitals. Results. The study found that the prevalence rate of DAMA was 33.3%. There was a significant association between the sociodemographic and clinical characteristics of patients with chronic diseases and DAMA. Health insurance found to be the strongest predictor of DAMA. Finally, the study found that patient, hospital, and environmental- related factors had a low impact on DAMA. Conclusions: DAMA is prevalent among patients with chronic diseases in Jordan during COVID-19 pandemic. The current study’s findings can serve as an empirical basis for planning and implementing DAMA prevention programs and/or establishing or revising policies for the target population.