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Concerns about neonates discharged against medical advice from the neonatal intensive care unit
QIAO Ning-Ning, GONG Ming-Hua, JIN Zhen-Ai
Chinese Journal of Contemporary Pediatrics ›› 2017, Vol. 19 ›› Issue (2) : 254-258.
PDF(480 KB)
PDF(480 KB)
Concerns about neonates discharged against medical advice from the neonatal intensive care unit
Discharge against medical advice (DAMA) conflicts with the purpose of disease treatment in children. Some research has shown that there are high proportions of extremely preterm infants and infants with asphyxia or congenital malformation in neonates with DAMA. This suggests that the sustainable development of neonatology needs cooperation and co-development with obstetrics, neonatal surgery, and radiology to reduce the rate of DAMA. With reference to the current status of research in both China and other countries, this article reviews the causes for DAMA and the strategies for reducing the rate of DAMA, in order to provide a theoretical basis for effectively reducing the rate of DAMA from the neonatal intensive care unit, improving treatment outcomes of the neonates, and increasing hospitals’ comprehensive benefits.
Discharge against medical advice / Cause / Strategy / Neonate
[1] 林小波,魏亮瑜.患者家属要求自动出院时医方注意义务的探讨[J].中华医院管理杂志,2012,28(3):231-234.
[2] Hadadi A,Khashayar P,Karbakhsh M,et al.Discharge against medical advice from a Tehran emergency department[J].Int J Health Care Qual Assur,2016,29(1):24-32.
[3] 高红达,罗红叶,王翾,等.2008~2010年广西县级妇幼保健院医疗质量的综合评价[J].中国妇幼保健,2015,30(13): 1973-1974.
[4] Schaefer GR,Matus H,Schumann JH,et al.Financial responsibility of hospitalized patients who left against medical advice:medical urban legend?[J].J Gen Intern Med,2012, 27(7):825-830.
[5] Kim H,Colantonio A,Bayley M,et al.Discharge against medical advice after traumatic brain injury:is intentional injury a predictor?[J].J Trauma,2011,71(5):1219-1225.
[6] Odetunde OI,Okafor HU,Uwaezuoke SN,et al.Chronic kidney disease in children as seen in a tertiary hospital in Enugu,South-East,Nigeria[J].Niger J Clin Pract,2014,17(2):196-200.
[7] 赵德安,张宝芹.普通儿科住院患者自动出院的原因分析[J]. 医学与哲学,2013,34(12B):59-61.
[8] Kareliusson F,De Geer L,Tibblin AO.Risk prediction of ICU readmission in a mixed surgical and medical population[J].J Intensive Care,2015,3(1):30.
[9] Al-Sadoon M,Al-Shamousi K.Discharge against medical advice among children in Oman:a university hospital experience[J]. Sultan Qaboos Univ Med J,2013,13(4):534-538.
[10] Onukwugha E,Saunders E,Mullins CD,et al.Reasons for discharges against medical advice:a qualitative study[J].Qual Saf Health Care,2010,19(5):420-424.
[11] Onukwugha E,Saunders E,Mullins CD,et al.A qualitative study to identify reasons for discharges against medical advice in the cardiovascular setting[J].BMJ Open,2012,2(4):1-7.
[12] Sheikhmoonesi F,Khademloo M,Pazhuheshgar S.Patients discharged against medical advice from a psychiatric hospital in Iran:a prospective study[J].Glob J Health Sci,2014,6(3):213-218.
[13] Noohi K,Komsari S,Nakhaee N,et al.Reasons for discharge against medical advice:a case study of emergency departments in Iran[J].Int J Health Policy Manag,2013,1(2):137-142.
[14] 倪美艳,陈娟.早产儿脑病的临床研究进展[J].中华妇幼临床医学杂志(电子版),2014,10(5):113-116.
[15] Nyp MF,Taylor JB,Norberg M,et al.Impaired growth at birth and bronchopulmonary dysplasia classification:beyond small for gestational age[J].Am J Perinatol.2015,32(1):75-82.
[16] Sahni R,Polin RA.Physiologic underpinnings for clinical problems in moderately preterm and late preterm infants[J].Clin Perinatol,2013,40(4):645-663.
[17] 黄小玲,许丽萍,张浩,等.晚期早产儿718例早产原因及并发症分析[J].现代医药卫生,2016,32(3):420-421.
[18] 周欣,殷茵,张国英,等.2008-2012年1466例早产回顾性临床分析[J].国际妇产科学杂志,2014,41(4):434-437.
[19] Glass HC,Costarino AT,Stayer SA,et al.Outcomes for extremely premature infants[J].Anesth Analg,2015,120(6):1337-1351.
[20] 崔银珠,张谦慎,贺红云,等.超未成熟儿的生存状况与预后影响因素[J].中国当代儿科杂志,2014,16(6):596-600.
[21] 曾军安,李占魁,李清红,等.117例极低和超低出生体重儿并发症及结局分析[J].中国妇幼健康研究,2015,26(4):724-726.
[22] 陆丹苏,童笑梅.超低出生体重儿生存状况分析[J].中国儿童保健杂志,2013,21(4):388-391.
[23] 赵文婷,俞惠民.早产儿脑室旁白质损伤发病机制的研究进展[J].中国当代儿科杂志,2013,15(5):396-400.
[24] 公明花,金贞爱,赵一坤,等.193例未愈出院新生儿回顾性分析[J].中国妇幼保健,2015,30(1):76-78.
[25] 郁静茹,金蕾,肖利华,等.2006~2012年北京市通州区出生缺陷患病率的动态变化[J].中国当代儿科杂志,2014,16(11): 1133-1137.
[26] 郭孝涵,贺晶.环境因素与出生缺陷[J].国际妇产科学杂志, 2013,40(6):537-540.
[27] Sun L,Yue H,Sun B,et al.Estimation of birth population-based perinatal-neonatal mortality and preterm rate in China from a regional survey in 2010[J].J Matern Fetal Neonatal Med,2013, 26(16):1641-1648.
[28] Auger N,Bilodeau-Bertrand M,Nuyt AM.Dangers of death on the first day of life by the minute[J].J Perinatol,2015,35(11): 958-964.
[29] 张艳.2010-2014年深圳市坪山新区围产儿出生缺陷监测分析及干预探讨[J].中国健康教育,2016,32(4):367-368.
[30] Committee on Understanding Premature Brith and Assurling Healthy Outcomes.Preterm birth:causes,consequences,and prevention[R].Washington,DC:National Academies Press,2007.
[31] Howe TH,Sheu CF,Wang TN,et al.Parenting stress in families with very low birth weight preterm infants in early infancy[J].Res Dev Disabil,2014,35(7):1748-1756.
[32] Cavallo MC,Gugiatti A,Fattore G,et al.Cost of care and social consequences of very low birth weight infants without prematurerelated morbidities in Italy[J].Ital J Pediatr,2015,41:59.
[33] 哈力,袁梦鸿.2种神经节苷脂药物治疗新生儿缺氧缺血性脑病的疗效对比及最小成本分析[J].中国药房,2006,17(8): 592-594.
[34] 伍莉,王楠.影响新生儿重症监护室医患沟通的因素及处理办法[J].中国医药指南,2016,14(15):291-292.
[35] 陈思,丁烯,朱雪峰,等.某院儿科住院病人自动出院原因分析[J].现代预防医学,2006,33(8):1041-1042.
[36] 李东玲.心内科住院患者自动出院原因及动向调查分析[J]. 齐鲁护理杂志,2008,14(9):33-34.
[37] Hadadi A,Khashayar P,Karbakhsh M,et al.Discharge against medical advice from a department[J].Int J Health Care Qual Assur,2016,29(1):24-32.
[38] Callen PW.Ultrasonography in Obstetrics and Gynecology[M]. 4th ed.Philadelphia:WB Saunders,2000:2.
[39] 贾索红.超声检查对产前筛查胎儿先天畸形的临床价值[J]. 贵州医药,2016,40(1):82-83.
[40] 李娟,王庆红,吴红敏,等.2005年中国城市产科新生儿出生状况调查[J].中国当代儿科杂志,2012,14(1):7-10.
[41] 欧阳秋星,王莹莹.新生儿重度窒息原因分析与复苏后抢救措施[J].西部医学,2015,27(5):86-88.
[42] 王予倩.新生儿窒息复苏在临床中的应用[J].世界最新医学信息文摘,2015,15(19):48-49.
[43] 陈克正.建立我国新生儿的转运系统[J].中华儿科杂志, 2000,38(8):527-528.
[44] 中国医师协会新生儿专业委员会.中国新生儿转运指南(2013)[J].中华实用儿科临床杂志,2013,28(2):153-155.
[45] 文秀敏,赵洁,龙艳明,等.建立新生儿转运网在临床的实践意义[J].数理医药学杂志,2015,28(9):1390-1391.
[46] 马月丹,胡冬梅,于润吉.我国儿童医疗保障体系发展现状及对策[J].中国卫生经济,2007,26(8):51-52.
[47] Kucik JE,Cassell CH,Alverson CJ,et al.Role of health insurance on the survival of infants with congenital heart defects[J].Am J Public Health,2014,104(9):62-70.
[48] 徐思思,叶洋,潘相吉,等.医学伦理委员会的建设现状及治理机制研究[J].中国医学伦理学,2016,29(1):17-19.
[49] 袁可,谢宗德.新生儿重症监护室放弃治疗的伦理问题[J].医学与哲学(临床决策论坛版),2006,27(6):70-71.
[50] 邹明明,李枞,刘利丹,等.临床医师医学人文认知情况的问卷分析:大连医科大学、哈尔滨医科大学、南京医科大学、河北医科大学、重庆医科大学联合调查之一[J].医学与哲学, 2013,34(8):12-17.
