caa a22 4500 397519990 CHVBK 20180308164630.0 cr unu---uuuuu 161202e199503 xx s 000 0 eng 10.1093/heapol/10.1.89 doi (NATIONALLICENCE)oxford-10.1093/heapol/10.1.89 Pediatric discharge against medical advice in Bouake, Cote d'lvoire, 1980-1992 [Elektronische Daten] [STEPHEN GLOYD, AHOUA KONE, ABOLÉ ENGBAKO VICTOR] Discharge information was obtained from pediatric ward logbooks of the Centre Hospitalier Régional de Bouaké from 1982 to 1992. While number of children admitted per month and discharge diagnosis remained relatively stable throughout the period, the proportion of children who left the hospital against medical advice increased by nearly 5 times during the 11-year period to over 12% of all pediatric admissions. The proportion of discharges against medical advice decreased to 10% of all pediatric admissions after institution of a programme to provide essential drugs at cost to patients (previously only available from private pharmacies). Most children who were taken from the hospital left within the first two days of hospitalization. The admission diagnoses of these children suggest that most had serious, life-threatening illness and that they left the hospital prior to having received adequate treatment. The increase in pediatric ward discharge against medical advice occurred simultaneously with serious budgetary shortfalls in the hospital resulting in inadequacy of medicines and basic equipment. Hospital staff suspected that most of the discharges against medical advice were caused by families being unable to afford the purchase of medicines and supplies necessary for inpatient treatment. It is suggested that widespread policies of decreasing funding for basic curative services in public hospitals may be associated with a substantial increase in preventable child mortality. © Oxford University Press Research report nationallicence GLOYD STEPHEN University of Washington School of Public Health / Community Medicine Seattle, USA aut KONE AHOUA Health Alliance International Seattle, USA aut VICTOR ABOLÉ ENGBAKO Centre Hospitalier Regional de Bouaké, Bouaké, Cote d'lvoire aut Health Policy and Planning Oxford University Press 10/1(1995-03), 89-93 0268-1080 10:1<89 1995 10 heapol https://doi.org/10.1093/heapol/10.1.89 text/html Onlinezugriff via DOI 1 other jats NATIONALLICENCE 856 40 https://doi.org/10.1093/heapol/10.1.89 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- GLOYD STEPHEN University of Washington School of Public Health / Community Medicine Seattle, USA aut NATIONALLICENCE 700 1- KONE AHOUA Health Alliance International Seattle, USA aut NATIONALLICENCE 700 1- VICTOR ABOLÉ ENGBAKO Centre Hospitalier Regional de Bouaké, Bouaké, Cote d'lvoire aut NATIONALLICENCE 773 0- Health Policy and Planning Oxford University Press 10/1(1995-03), 89-93 0268-1080 10:1<89 1995 10 heapol Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford