Leave against Medical Advice in Children: Rural Indian Perspective.

Abstract:

OBJECTIVES:To determine the burden and etiological factors of leave against medical advice (LAMA) in Indian children. METHODOLOGY:In this prospective study, legal guardians of 528 patients who took the decision of LAMA were interviewed (using structured question answers based multi-option) and data were captured over a period of 16 months. The resultant database was analyzed using standard statistical methods. RESULTS:About 6.12% of childhood LAMA cases were dealt out of total pediatric admission including newborns. Neonatal preponderance noted in cases of LAMA from intensive care unit (ICU; 57.14%, p < 0.05). The overall male (n = 293) to female (n = 235) ratio in this study was 1.25:1. Number of LAMA patients was higher from rural area (83.33%), mostly admitted in ICU (93.65%, Pearson's chi-squared test, p < 0.05). Higher proportion (29.47%) of patients with infection availed LAMA from neonatal age group but overall LAMA patients fall under category of respiratory disorders (22.35%). Interest of the domestics issues other than suffering child was considered primary during LAMA for those admitted in ward as compared with ICU patients [odds ratio (OR): 1.73, CI: 1.02-2.94, p < 0.05]. ICU patients were reportedly to be taken to private health care facility (OR: 1.93, CI: 1.06-3.49, p < 0.05). Duration of stay before taking LAMA from ward was <7 days (85.59%, OR: 0.19, CI: 0.11-0.35, p < 0.05). Upper-lower socio-economic class attributed financial constraint as the main reason for LAMA (Pearson's chi-squared test, Chi-square value: 152.23, p < 0.05). CONCLUSIONS:This study tried to elucidate the determinants of childhood LAMA in rural Indian setting.

journal_name

J Trop Pediatr

authors

Datta D,Mondal T,Sarkar M,Chel S,Das SK,Nandy A,M Ivan D,Mondal R

doi

10.1093/tropej/fmaa110

subject

Has Abstract

pub_date

2020-12-21 00:00:00

eissn

0142-6338

issn

1465-3664

pii

6043117

pub_type

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