Retrospective Report of Discharge Against Medical Advice and Emerging Roles of Medical Social Workers in Nigeria

Abstract

The study presents a retrospective report of cases of DAMA and the emerging roles of Medical Social Workers in Nigeria using a teaching hospital as a case. Retrospective report of 553 DAMA cases were retrieved from social case-note of Medical Social Workers between a period of five years (June, 2015 to December, 2019) at University College Hospital, Ibadan Reasons for DAMA were mostly because of financial constraints. Medical Social Worker’s intervention were hovering around education and facilitating legal procedure to DAMA to prevent litigation to the hospital. There was an association between socio-demographic characteristics and rates of DAMA (p<0.05), diagnosis of patient was also significantly associated with rate of DAMA in the hospital(p<0.05) and there was an association between gender and social work interventions to cases of DAMA at the University College Hospital(p<0.05). The study concluded that high rate of DAMA in Nigerian hospital is as a result of differences in socioeconomic characteristics of patients and severity of their diagnosis. Therefore, hospital admission processes should be person-cantered care services and inclusion of Medical Social Workers in the flow-char of granting DAMA to patients