Cases of Left Against Medical Advice from the Emergency Department of a Tertiary Care Hospital in Kathmandu: A Descriptive Cross-Sectional Study

Introduction: Left against medical advice is a worldwide phenomenon. Patients leaving against Left against medical advice does not provide the health professionals from legal impunity. A wellinformed consent should be present with surety that they are well understood by the patient before they leave. The study was undertaken to study the prevalence of patients that leave against medical advice in a tertiary care center. Methods: This is a descriptive cross-sectional study done in the emergency department of a tertiary care hospital from 1st February 2020 to 31st July 2020. Ethical approval was taken from the Institutional Review Committee (ref. no. 130120205). The sample size was calculated and the convenient sampling method was used. Data were analyzed in the Statistical Package of the Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 5834 visits, 332 (5.96%) (4.70-7.22 at 95% Confidence Interval) patients left against medical advice. The mean age was 36.48 years (3 days-91 years) and males 173 (52.3%) were prone to leave than females. Only 50 (15.1%) cases had well-informed consent with complications documented. Hundred (30.5%) patients had wanted to come on follow up the next day in the outpatient department while 41 (12.4%) had to leave because of financial reasons. Only seven (2.9%) of well-oriented patients gave their consent and the remaining 233 (97.1%) was by the kin present. Only 76 (23%) patients were sent home with a well-documented medicine prescription. Conclusions: The proportion of patients who left against medical advice was more than the studies done in the similar setting.