Table 1:
Characteristics of reviewed articles
| DAMA cause (%)* | DAMA-Male Gender (%) | DAMA Prevalence (%) | Sample and sample size | City | Reference Number |
|---|---|---|---|---|---|
|
Patient- related reasons: financial constraint (7.9), family problems (3.4), feeling of wellbeing (59.7), Be traveler (6.2). Hospital condition: Nurse and Physician negligence (15.5), Inappropriate behavior (5/4), physician’s suggestion (18), absence of timely physician (6.2), lack of skilled medical staff (18/3), Improper cleaning (3.7), inadequate equipment (5.6), poor nutrition (1.1), unsuitable environment (8.2). |
56.6 | 1100 (4.2) | Children-26089 | Mashhad | 18 |
| Hospital staff- related reason (16.5), treatment related reason (39.2), Hospital condition (23.2), Patient- related reasons (54.0) | - | 237 (4.6) | General patients - 5137 | Urmia | 21 |
|
Patient- related reasons: financial constraint (3.1), family problems (20.1), fear of treatment (5.1), patient job (4.5), no have family member in hospital (12.2), feeling of wellbeing (28.4), Be traveler (26.2) Hospital condition: Nurse and Physician negligence (34.3), Inappropriate behavior (13), absence of timely physician (18.8), lack of skilled medical staff (30.4), improper cleaning (9.4), inadequate equipment (19.8), poor nutrition1 (8.6), unsuitable environment (6.2), other (3.3) |
55.5 | 2026 (10.3) | General patients- 19660 | 8 | |
|
Patient- related reasons: feeling of wellbeing (20), unhopeful from treatment (3), Transferring to another hospital (4), Transportation problem (7), Lack of consent to surgery or invasive procedures (5), holiday (3), not have family support (3), refer to previous doctor (10) Hospital condition: fear of hospital infection (20), Inappropriate behavior (7), inadequate equipment (2), absence of timely physician (2), treatment by medical students (6), couldn’t choice a doctor (8) |
59/6 | 483 (5.1) | General patients- 9295 | Kerman | 22 |
|
Patient- related reasons: Disappearance of symptoms (35.6), Lack of insight (25.6), Missing family (18.9), Economic problem (12.2), Fear of other patients (10) Hospital condition: Boredom from ward environment (16.7), Anger over given treatment (8.9), Lack of trust to the doctor (3.3), Lack of satisfaction with staff behavior (4.4), other (8.9) |
41.7 | 403 (34.4) | psychiatric wards patients- 1171 | Sari | 23 |
|
Patient- related reasons: Feeling complete recovery (45.4), Transferring to another hospital (15.1), The patient’s personal reasons (5.8), Going to home (4.5), Financial problems (1.3) Hospital condition: Lack of required facilities (7.3), Not paying full and close attention to the patients (5.1), Hospital intolerance (3.1), Prolonged treatment process (2.8), Dissatisfaction with the hospital (2.8), Lack of required special medical services (1.7), Overcrowding in the unit and department (1.5) |
65.3 | 2601 (14) | General patients- 18518 | Tehran | 24 |
|
Patient- related reasons: Perceived improvement of child illness (32.9), Financial problems (15.5), Hospital condition: Unsatisfactory treatment and care (29.9), Inconvenience for child hospitalization (18.6), not declared (3.1) |
56.7 | 97 (5.3) | Children- 1842 | Tehran | 20 |
| - | - | 31 (3.4) | psychiatric wards patients-908 | Tehran | 25 |
| - | 61 | 121 (5.6) | Emergency Department- 2161 | Kerman | 27 |
| Hospital condition: Dissatisfaction from physician (33), Advice of the doctor (27.5), Lack of required facilities (12.7), Dissatisfaction from nurses (9.3), unsuitable environment (6.6), hospital cost (3.6), others (3.9) | 65.3 | 330 (8.2) | General patients- 4017 | Ghazvin | 31 |
| Patient- related reasons: Feeling of recovery (12), Personal reason (13.9), Transportation (7.5), Follow up (0.9), Unknown (65.7) | 52.7 | 108 (2.2) | Children- 4835 | Sari | 26 |
|
Patient- related reasons: Feeling better (47.1), Financial problems (4), Referring to a private center (10.5), Referring to certain centers due to personal ties (7.5) Hospital condition: Oral statements of physicians regarding improved conditions (9.2), No ICU bed (2), No CCU bed (1.1), No inpatient bed (2.1), Lack of appropriate specialty (2.7), Advice of the doctor and staff to refer to other centers (4.6), Unaccountability of the physician and the staff (3.1), Poor attendance (0.8), Over-crowding and insufficient care (1.4), Dissatisfaction with the course of treatment (3.3) |
58.4 | 1502 (13.3) | Emergency Department-13309 | Tehran | 32 |
|
Patient- related reasons: Lack of consent to surgery or invasive procedures (30.8), Personal or family issues (16.8), Feeling well (12.9), Financial problems (11.1), Desire to be transferred to another hospital (10.1), Requesting temporary leave from hospital stay during public or extended holidays (2.9), No noticeable improvements (5.9), No reason mentioned (2.8) Hospital condition: Dissatisfaction with hospital services/facilities (2.3), Seeking consultation elsewhere (1.4), Delay in delivery of health care services (0.8), Dissatisfaction with the staff’s behavior (0.7), Other reasons (1.5) |
59.5 | 992 (4.9) | In patients with Heart Disease- 20289 | Tehran | 9 |
| - | 56.3 | 860 (9) | General patients- 9463 | Shiraz | 10 |
| - | 51.1 | 7967 (8.4) | General patients-94441 | Mazandaran | 30 |
|
Patient- related reasons: Feeling better (78), Tendency to refer to a better center (7.7), Not having tendency to hospitalization (8.9) Hospital condition: Lack of expert physicians (0.3), Lack of suitable services (2), Ward being over crowded (2.3), Need to hospitalization in special units such as ITU or CCU (2.1), other (1.3) |
67.3 | 1516 (11.8) | Emergency Department- 12843 | Tehran | 29 |
| - | - | 178 (20.2) | emergency department-880 | Tehran | 19 |
*
”Patient- related reasons” and ”Hospital condition” are two main them of DAMA cause