右江医学2026，Vol.54Issue(5)：476-482,7.DOI:10.3969/j.issn.1003-1383.2026.05.009
2024年南宁市三所妇幼保健院非医嘱离院特征及因素分析
Analysis of the characteristics and factors of discharge against medical advice from three maternal and child health care hospitals in Nanning City in 2024
摘要
Abstract
Objective To analyze the distribution characteristics of discharge against medical advice(DAM A)among inpatients in three maternal and child health hospitals in Nanning City in 2024,and explore the impact of psychosocial factors on DAM A,so as to provide evidence for formulating intervention strategies.Methods A prospective study design was adopted,and the medical record data of 10 039 discharged patients from Nanning Maternal and Child Health Hospital,the Reproductive Hospital of Guangxi Zhuang Autonomous Region,and Mashan Maternal and Child Health Hospital from January to December 2024 were collected.The incidence of DAMA and its distribution characteristics by department and disease type were calculated.In addition,multivariate logistic regression model was used to analyze the influencing factors of DAMA.Results Among the 10 039 discharged patients,368 cases were DAM A,with an incidence rate of 3.67％.The DAMA patients were mainly concentrated in pediatrics(264 cases,71.74％),neonatology(41 cases,11.14％),and obstetrics(33 cases,8.97％).The main disease types were respiratory system diseases(258 cases,70.11％),digestive system dis-eases(46 cases,12.50％),and pregnancy-related diseases(38 cases,10.33％).Multivariate logistic regression analysis showed that severe condition(OR=3.083)and treatment cost≥10 000 yuan(OR=3.397)were identified as independent risk factors for DAMA(all P＜0.01);length of stay＜7 days(OR=0.510),admission through outpatient/other channels(OR=0.520),high score on the general self-efficacy scale(GSES)(OR=0.471),and high score on the perceived social support scale(PSSS)(OR=0.440)were protective factors(all P＜0.01).Conclusion The occurrence of DAMA in the three maternal and child health hospitals in Nanning City is closely related to length of hospital stay,admission route,severi-ty of condition,treatment cost,patients' self-efficacy and social support level.Hospitals can develop hierarchical intervention strategies based on the above-mentioned characteristics and influencing factors to reduce the incidence of DAMA.关键词
非医嘱离院/分布特征/心理社会因素/自我效能Key words
discharge against medical advice(DAMA)/distribution characteristic/psychosocial factor/self-efficacy分类
医药卫生引用本文复制引用
卢芳玲,韦慧,李楠,黄玲,罗金云..2024年南宁市三所妇幼保健院非医嘱离院特征及因素分析[J].右江医学,2026,54(5):476-482,7.基金项目
广西医疗卫生适宜技术开发与推广应用项目(S2024127) （S2024127）
