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- Title
Patients discharged against medical advice from a general medicine service.
- Authors
Weingart, Saul N.; Davis, Roger B.; Phillips, Russell S.; Weingart; Weingart, S N; Davis, R B; Phillips, R S
- Abstract
This study compares the demographic features and hospital course of all 472 patients discharged against medical advice from the general medicine service of an urban teaching hospital between 1984 and 1995 and 1,113 control patients discharged with physician approval. In the multivariate analysis, younger age (odds ratio [OR] 0.97 per year; 95% confidence interval [CI] 0.96, 0.98), male gender (OR 1.9; 95% CI 1.4, 2.4), lack of health insurance (OR 2.0; 95% CI 1.3, 3.1), Medicaid applicant or recipient status (OR 2.2; 95% CI 1.6, 3.1), admission through the emergency department (OR 2.2; 95% CI 1.4, 3.5), and lack of a personal attending physician at the time of admission (OR 2.1; 95% CI 1.6, 2.8) increased the odds of discharge against medical advice. Fifty-four percent of patients who left against medical advice were readmitted to the hospital during the study period; 98% were then discharged with physician approval. Patients who left the hospital against medical advice included many disadvantaged individuals without ongoing primary care.
- Subjects
UNITED States; PATIENTS; ACADEMIC medical centers; CUSTOMER relations; HEALTH services accessibility; LENGTH of stay in hospitals; LONGITUDINAL method; STATISTICS; URBAN hospitals; DATA analysis; PATIENT refusal of treatment; DISCHARGE planning; CASE-control method; PATIENT readmissions
- Publication
JGIM: Journal of General Internal Medicine, 1998, Vol 13, Issue 8, p568
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1046/j.1525-1497.1998.00169.x