Premature discharge of children from hospital admission at Ahmadu Bello University Teaching Hospital Zaria: A 3-year review

Abstract

Introduction: Leaving hospital care prematurely could threaten the healthy survival of and expose children to a risk of harmful alternatives. It is also a concern and a challenge to healthcare providers and the health system. A better understanding of its characteristic could help mitigate the impact on children.
Objective: To determine the prevalence, types of, and reasons for premature hospital discharge amongst children.
Methods: We carried out a threeyear retrospective review of case notes of children who were taken away from hospital admission by their parents/caregivers before they were due for discharge.  Socio-demographic, clinical anddischarge information were collected and data was entered into Microsoft® Excel® for Mac 2011 (Version 14.1.0), cleaned and analysed. Results were presented as percentages, statistical means and standard deviations, tables and charts.
Results: There were 56 cases of premature discharge out of 2858 admissions, giving a prevalence of 2.0%. Under-five children constituted 65.4%, with a male: female ratio of 2.3:1. Thirty-one (55.3%) children were absconded with while 25 (44.7%) were taken away by caregivers against medical advice. The commonest diagnoses were protein-energy malnutrition and pneumonia and majority were from poor socio-economic family background. The commonest reasons for discharge AMA were unaffordable costs and perception of improvement of child’s medical condition.
Conclusion: Socio-economic factors were significant determinants of utilization of in-patient hospital services for the children studied. There is a need for provision of affordable health care as well as efficient discharge policy to protect children from potential risks associated with premature hospital discharge.

Keywords: Children; admission; premature discharge; discharge against medical advice; absconding; elopement