ArticleAmerican journal of public health2007
Factors associated with patients who leave acute-care hospitals against medical advice.
Article in American journal of public health, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers.
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Who cites it
81 citing papers in PubMed.
- Interprofessional Hospital Addiction Consults Are Associated with Decreased Patient-Directed Discharges.Journal of general internal medicine · 2026Article
- Wave-aware mortality prediction in COVID-19: a multi-stage feature selection and explainable machine-learning framework.BMC medical informatics and decision making · 2026Article
- "He said he could take his own advice": Stigmatizing language in notes documenting discharges against medical advice.Journal of hospital medicine · 2026Article
- Discharge against medical advice among pediatric patients: A retrospective study from a Saudi tertiary emergency department.Saudi medical journal · 2025Article
- Predicting drug overdose and death after "before medically advised" hospital discharge.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Article
- Improving Equity at Premature Discharge: Reframing Discharge Against Medical Advice Using the Structural Competency Framework.Journal of general internal medicine · 2025Article
- Discharge Against Medical Advice From the Emergency Department: Results From a Private Hospital in Beirut.Cureus · 2025Article
- Care Complexity Factors and Discharge Destination in an Emergency Department: A Retrospective Cohort Study.Archives of academic emergency medicine · 2025Article
- Factors Influencing Patient Decisions to Discharge Against Medical Advice from Hospital Emergency: Insights From a Saudi Tertiary Hospital.Journal of patient experience · 2025Article
- Socioeconomic differences in discharge against medical advice and hospital admission among emergency department visits associated with substance use in the United States.Frontiers in public health · 2025Article
- Patient-Physician Sex Discordance and "Before Medically Advised" Discharge from Hospital: A Population-Based Retrospective Cohort Study.Journal of general internal medicine · 2024Article
- "Before medically advised" departure from hospital and subsequent drug overdose: a population-based cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Article
- Quantitative Analysis of Characteristics Associated with Patient-Directed Discharges, Representations, and Readmissions: a Safety-Net Hospital Experience.Journal of general internal medicine · 2024Article
- Rates and Characteristics of Patients Leaving against Medical Advice after Spine Surgery.Spine surgery and related research · 2024Article
- Race and Ethnicity and Emergency Department Discharge Against Medical Advice.JAMA network open · 2023Article
- Addiction Consult Service and Inpatient Outcomes Among Patients with Alcohol Use Disorder.Journal of general internal medicine · 2023Article
- Comparison between healthcare quality in primary stroke centers and comprehensive stroke centers for acute stroke patients: evidence from the Chinese Stroke Center Alliance.The Lancet regional health. Western Pacific · 2023Article
- Closing the health gap in Central Australia: reduction in Indigenous Australian inpatient self-discharge rates following routine collaboration with Aboriginal Health Workers.BMC health services research · 2023Article
21 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
objectivesWe examined hospital- and patient-related factors associated with discharge against medical advice (termed self-discharge) after emergency admission to acute-care hospitals.
methodsWe analyzed data from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project using logistic regression models to assess the relationship between self-discharge and a set of patient and hospital characteristics.
resultsOf 3,039,050 discharges in the sample, 43 678 were against medical advice (1.44%). In multivariable modeling, predictors of self-discharge included having Medicaid insurance (adjusted odds ratio [AOR]=3.32; 95% confidence interval [CI]=3.22, 3.42), having Medicare insurance (AOR=1.64; 95% CI=1.59, 1.70), urban location (AOR=1.66; 95% CI=1.61, 1.72), medium (AOR=1.25; 95% CI=1.20, 1.29) or large (AOR=1.08, 95% CI=1.05, 1.12) hospital (defined by the number of beds), shorter hospital stay (OR=0.84; 95% CI=0.84, 0.85), and African American race (AOR=1.10; 95% CI=1.07, 1.14). Teaching hospitals had fewer self-discharges (AOR=0.90; 95% CI=0.88, 0.92). Other predictors of discharge against medical advice included age, gender, and income.
conclusionsApproximately 1 in 70 hospital discharges in the United States are against medical advice. Both hospital and patient characteristics were associated with these decisions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.