Karel Kostev, Ira Rodemer, André Hajek, Marcel Konrad, Lee Smith
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引用次数: 0
Abstract
Background: The objective of this study was to investigate the prevalence of discharge against medical advice (DAMA) among schizophrenia patients in Germany and to identify factors associated with the risk of DAMA.
Methods: This multicenter cross-sectional study was based on data from the IQVIA hospital database, which contains records from 36 hospitals across Germany. This study included all hospitalizations for patients with a primary or secondary diagnosis of schizophrenia between January 2019 and December 2023. Multivariable logistic regression analyses adjusted for age, sex, primary or secondary schizophrenia diagnosis, as well as codiagnoses, were conducted to assess the associations between demographic and clinical variables and DAMA.
Results: A total of 7663 hospitalization cases (mean age: 49.5 years, 40.6% female) were included in the study. The DAMA rate was 31.1% in patients with schizophrenia as the primary diagnoses and 6.0% in patients with schizophrenia as a secondary diagnosis. Younger age (i.e., adjusted odds ratio (aOR): 7.44; 95% CI: 4.35-12.73 in the age group 18-30; aOR: 6.63; 95% CI: 3.89-11.29 in the age group 31-40; aOR: 5.59; 95% CI: 3.28-9.54 in the age group 41-50), schizophrenia as the primary diagnosis (aOR: 3.61; 95% CI: 3.05-4.26), alcohol-related disorders (aOR: 1.68; 95% CI: 1.38-2.04), and cannabis-related disorders (aOR: 1.43; 95% CI: 1.18-1.72) were significantly associated with an increased risk of DAMA.
Conclusions: This study highlights the high prevalence of DAMA among hospitalized schizophrenia patients and identifies the important factors (i.e., younger age, alcohol-related disorders, and cannabis-related disorders) associated with DAMA risk. Additional studies are recommended for further exploration into the reasons for DAMA.
期刊介绍：
Brain Sciences (ISSN 2076-3425) is a peer-reviewed scientific journal that publishes original articles, critical reviews, research notes and short communications in the areas of cognitive neuroscience, developmental neuroscience, molecular and cellular neuroscience, neural engineering, neuroimaging, neurolinguistics, neuropathy, systems neuroscience, and theoretical and computational neuroscience. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. Electronic files or software regarding the full details of the calculation and experimental procedure, if unable to be published in a normal way, can be deposited as supplementary material.
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