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SA Orthopaedic Journal

On-line version ISSN 2309-8309
Print version ISSN 1681-150X

Abstract

POPOOLA, SO; ONYEMAECHI, NOC; KORTOR, JN  and  OLUWADIYA, KS. Leave against medical advice (LAMA) from in-patient orthopaedic treatment. SA orthop. j. [online]. 2013, vol.12, n.3, pp.58-61. ISSN 2309-8309.

Leave Against Medical Advice (LAMA) poses potentially serious consequences on the utilisation of resources and may impact on an institution's finances. This study investigated hospital characteristics, patient factors and physician obligations regarding LAMA in Makurdi, Nigeria. A 12-month prospective study involving orthopaedic in-patients in a tertiary health institution with many catchment areas was conducted. A proforma was designed for the socio-demographic profiles and the contexts surrounding the act of LAMA.Fifty-eight (13.9%) of the patients managed within the stipulated period took LAMA. Injury sustained in motor vehicle collisions was the major indication for admission while disagreement on treatment modality and poor financial status were the main reasons for LAMA. The major destination after taking LAMA was the Traditional Bone Setter's home. 'Disagreement on treatment/duration' and 'patronage of the Traditional Bone Setters' are issues linked mostly to the poor financial status of patients. Educational awareness, implementation of health insurance for all citizens and establishment of a well-equipped orthopaedic division within the hospital are laudable solutions.

Keywords : Leave Against Medical Advice; orthopaedics.

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