Effects of Iranian Healthcare Transformation Plan on Discharge against Medical Advice

1Ayshe Hajiesmaeilpoor, Esmaeil Mohammadnejad, Alireza Shameli* and Fatemeh Sadat Izadi- Avanjic


Background: The Health care transformation plan (HCTP) is expected to improve the regulations and quality of the provided services in hospitals. The aim of this study was to evaluate the Effects of Iranian healthcare transformation plan on discharge against medical advice (DAMA) of Mazandaran University of Medical Sciences. Method: This descriptive-retrospective study was performed 2630 patients discharged during the two half-yearly time intervals before (2013-2014) and after (2015-2016), respectively. Data collection was by standard form of DAMA issued by the Ministry of Health and Medical Education. Data analyses were performed by descriptive statistics and inferential statistics. SPSS-16 software was used in this study and P values less than 0.05 were considered significant. Results: The level DAMA before and after introduction of the Healthcare Reform was 4.5 and 4.11 percent, respectively, which did not differ significantly (p = 0.889). In addition, there was no significant difference in the discharge level by age groups, hospital departments (p = 1), gender (p = 0.57), or holydays (p = 0.73). Conclusion: Our study did not find any evidence for the impact of the HCTP on frequency of the DAMA and the factors associated to it. However, the overall results implied necessity of a more comprehensive and integrated planning regarding supply of the required facilities, equipment, and human resources, as well as enlargement of physical space of treatment centers within the framework of this large-scale, nationwide program.


Discharge against Medical Advice, Patient Satisfaction, Healthcare Transformation, Patient Recovery.

Paper Details
IssueIssue 5