Journal of Medical and Surgical Research

6

Authors: Murat Saritemur

Introduction: Leaving against medical advice is a worrying situation which is a problem not only for patients also for physicians. For many different reasons, people may choose to leave the hospital on their own requests. If we know the reasons for leaving, we can find the solution. Method: This prospective study was conducted at an emergency department of a university hospital that is visited by more than 30.000 patients annually. Demographic characteristics such as sex and age, triage level, insurance status of the patients, length of stay in the emergency department and why they were leaving against medical advice were recorded. Results: A total of 321 patients which constituted 1.1% of all admissions to the emergency department during the study period left against medical advice. The main reason was refusing the observation or hospitalization (34.6%; n=111) and the second reason was inadequate health insurance (19.6%; n=63) in all study population (Table 1). Although inadequate health insurance was the second reason in males (36 of 153 patients; 24.0%), the second reason was refusing the intervention or medication in females (52 of 168 patients; 31.1%). The patients who left due to dissatisfaction with health care were predominantly male (72.7%; n=24; p=0.002) whereas who left due to refusing the intervention or medication were predominantly female (88.9%; n=48; p<0.001). Conclusion: Hospitals should endeavor to identify the reasons why patients leave the ED, to document the events in detail and also to solve the problem.

8

Authors: S. Housbane

In recent years, medical informatics has played an integral role in medicine, biology, and public health. The emergence of medical informatics as a discipline is largely due to advances in information technology, and an increasing awareness that biomedical knowledge about patients are essentially unmanageable by traditional paper-based methods. This study aims to develop a web application to assist endocrinologists in standard therapeutic protocols used in clinical and therapeutic aspects of endocrinology and drugs, and to contribute to a better management of drugs, and patient management recommendations. We outline key concepts as well as the application development stages of the application. The development of the application consists of defining needs, objectives and target audience, locating stakeholders and identifying their roles, modeling, choosing the most appropriate technology tools to reach the maximum targets, and finally developing the application. Endocrinology Prescription Support Application (EPSA) was developed for better information diffusion and communication within the endocrinology community. The application is enhanced by dynamic documents using small interactive scripts (JavaScript), e. g. Body Mass Index (BMI) calculation and interpretation. The use of these systems and their success rely on medical informatics which establishes connection and communication between computer scientists and endocrinologists to develop better integrated systems in their daily practice.