MADURAI: Over 3,615 patients were discharged from the Government Rajaji Hospital (GRH) Madurai, under Against Medical Advice (AMA) category, which translated to 1.86% of total in-patients in 2023. Experts have cited a number of reasons for the same.
According to the official records of GRH, Madurai, 1,94,284 persons were admitted as in-patients in the GRH Madurai in 2023. As many as 1,77,776 persons were discharged after availing proper medical care. However, 3,615 patients, who were receiving treatment, got discharged from GRH (Madurai).
AMA discharges continue to be a highly prevalent problem of the health care system, as this also defines the quality of health services. Discharge against medical advice AMA can be clearly defined as when a patient or their relative chooses to leave the hospital before the treating physician recommends discharge. AMA has obvious importance because of its potential to identify those at higher risk and therefore, intervene earlier to prevent excess morbidity, mortality, and health care expenses.
Former GRH Dean Dr Rathinavel said, "There are two reasons for cases which fall under AMA in GRH, Madurai. Nine out of 10 cases are related to moving out after the patient is about to die and to move out of the ventilator. As relatives feel that the patient must pass away in at home. On the other hand, if a person from an affluent family is admitted due to any road accident, after emergency treatment the family might feel the need for more facilities or extra care and move out.
Though such facilities are available in here, they prefer private hospitals and move out AMA. Only in some rare cases, a patient who received good treatment and discharges the next day. Some dengue patients who deduce that they are out of danger, also abscond from the medical facility. They are also counted under AMA category."
GRH Dean Dr L Arul Sundareshkumar said, "There could be a number of reasons for a patient's relative to be moving out of the facility against our medical advice. When we advise a patient about a particular treatment, the relatives refuse it and claim they could avail treatment elsewhere. Since, we cannot force anyone to remain in our facility, we discharge after offering 'against medical advice' to the family, as such a move can endanger the patient's life. Besides, we also conduct an internal audit about these cases to check with the medical practices."
