Study cites reasons why some children in Oman leave hospital early

Muscat: A new research has investigated the number of families, who get their children discharged against the instruction of their doctors at the Royal Hospital in Muscat.
The study, published in the latest issue of the Sultan Qaboos University Medical Journal, found that over a two-year period, 183 out of 11,482 children had left paediatric wards at Royal Hospital going against their doctors’ advice.
“It is encouraging to see that this number is relatively low, but we should be aiming for a prevalence of zero — no child should be discharged from the hospital before the completion of their treatment,” stated Dr. Mohammed Al Ghafri, the study’s first author and a doctor at Royal Hospital’s Intensive Care Unit.
The study found that dissatisfaction with treatment and the desire to seek a second opinion were the main reasons that families were getting their children discharged against medical advice.
Al Ghafri clarified that the parents’ dissatisfaction often stemmed from delays in certain investigations or procedures being performed, as well as a lack of single rooms in the paediatric wards.
“Also, some people do not trust medical services in Oman and they feel a better service will be provided abroad. If they can afford it, some will take their child to countries, such as Thailand or India for a second opinion and treatment,” he added.
The other reasons identified in the study were social or personal issues, such as problems with finding child care for the family’s other children. Financial concerns were only cited by 4.4 per cent of the families, all of whom were non-Omani and did not have medical insurance.
In Oman, if a child is discharged contrary to the doctor’s instruction, the parents need to sign a specific form and provide reasons for their decision. This protocol exists to protect hospitals against liability. In severe cases though, a legal order can be obtained by hospital staff in order to refuse a patient’s discharge request.
The consequences for leaving a hospital before the completion of treatment ranges from minimal to life-threatening, depending on the severity of the patient’s condition. According to Al-Ghafri, when a child’s treatment is stopped or delayed, this can have dire consequences for their health, particularly those with sepsis or newly diagnosed malignant tumours.
He also asserted that while the Royal Hospital is doing very well in treating a high volume of paediatric patients, some with very complicated illnesses, there is still more that can be done to prevent families from discharging their children against medical advice.
“Better communication between physicians and parents, avoiding unnecessary delays in performing investigations and procedures and having more private rooms in the paediatric wards might encourage more families to allow their child to continue care in hospital,” he continued.
The study concluded that further research should be done on the outcomes for children who leave paediatric wards before the completion of their treatment.