Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada
-
Palliative care is a routine, creative and important part of rural practice, well suited to practitioners who are used to finding practical solutions for their patients' care. A simple, clear approach may be effective for the physician, the patient and his family.
-
To understand the characteristics of patients who leave hospital against medical advice (known as "discharges against medical advice" [DAMA]) in a small community hospital and to study how these patients compare to current literature on the topic. To evaluate chart documentation pertaining to such discharges. ⋯ Patients who leave hospital against medical advice represent a high-risk population: they suffer a greater incidence of mental illness and substance abuse. Potential interventions are limited, but influence strategies may have a role. Early identification of patients at risk may facilitate this process, thereby decreasing the occurrence of DAMA and improving health outcomes. More consistent and comprehensive documentation is needed for these patients.