ArticleBMC health services research2013
A population-based analysis of leaving the hospital against medical advice: incidence and associated variables.
Article in BMC health services research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Leave events among Aboriginal and Torres Strait Islander people: a systematic review.BMC public health · 2022Pooled it
- Leaving the Hospital Against Medical Advice Among People Who Use Illicit Drugs: A Systematic Review.American journal of public health · 2015Pooled it
- Patient-Directed Discharge Among Hospitalized Persons With Opioid Use Disorder in the Fentanyl Era: A Scoping Review.American journal of medicine open · 2026Review
- Article
- Article
- Patients Discharged "Against Medical Advice" More than Once: A Cross-Sectional Descriptive Analysis of a Vulnerable Population.Journal of general internal medicine · 2025Article
- Retrospective Cohort Study to Determine the Effect of Socioeconomic Status and Distance to Hospital on Negative Appendicectomy Rates in a Rural Setting.The Australian journal of rural health · 2025Article
- An Epidemiological Survey of Hand Burn Injuries Admitted to a Large Burn Center in the New York City Metropolitan Area.Annals of plastic surgery · 2025Article
- Discharge Against Medical Advice Among Schizophrenia Patients in Germany: A Multicenter Cross-Sectional Study.Brain sciences · 2025Article
- Development and validation of risk prediction models for high-risk patients with non-traumatic acute abdominal pain: a prospective observational study.Frontiers in public health · 2025Observational
- The experiences of patients who leave hospital against medical advice: analysis of survey data.Frontiers in health services · 2025Article
- Discharge Against Medical Advice in Cancer Patients: Insights from a Multicenter Study in Germany.Cancers · 2024Article
- Review
- Risk Factors for Leaving Against Medical Advice in Patients Admitted for Upper Extremity Orthopedic Procedures.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Article
- Hospital and emergency department discharge against medical advice in Western Australian Aboriginal children aged 0-4 years from 2002 to 2018: A cohort study.Paediatric and perinatal epidemiology · 2023Article
- Rates, Reasons, and Independent Predictors of Readmissions in Portal Venous Thrombosis Hospitalizations in the USA.Gastroenterology research · 2022Article
- Sex Differences in Characteristics of Patients with Infective Endocarditis: A Multicenter Study.Journal of clinical medicine · 2022Article
- Letter to the Editor re: Hearts and Minds: an Exercise in Clinical Reasoning.Journal of general internal medicine · 2022Article
- Initiation of Buprenorphine/Naloxone on Rates of Discharge Against Medical Advice.Hospital pharmacy · 2022Article
- "I'm outta here!": a qualitative investigation into why Aboriginal and non-Aboriginal people self-discharge from hospital.BMC health services research · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrior studies of patients leaving hospital against medical advice (AMA) have been limited by not being population-based or assessing only one type of patient.
methodsWe used administrative data at the Manitoba Centre for Health Policy to evaluate all adult residents of Manitoba, Canada discharged alive from acute care hospitals between April 1, 1990 and February 28, 2009. We identified the rate of leaving AMA, and used multivariable logistic regression to identify socio-demographic and diagnostic variables associated with leaving AMA.
resultsOf 1,916,104 live hospital discharges, 21,417 (1.11%) ended with the patient leaving AMA. The cohort contained 610,187 individuals, of whom 12,588 (2.06%) left AMA once and another 2986 (0.49%) left AMA more than once. The proportion of AMA discharges did not change over time. Alcohol and drug abuse was the diagnostic group with the highest proportion of AMA discharges, at 11.71%. Having left AMA previously had the strongest association with leaving AMA (odds ratio 170, 95% confidence interval 156-185). Leaving AMA was more common among men, those with lower average household incomes, histories of alcohol or drug abuse or HIV/AIDS. Major surgical procedures were associated with a much lower chance of leaving the hospital AMA.
conclusionsThe rate of leaving hospital AMA did not systematically change over time, but did vary based on patient and illness characteristics. Having left AMA in the past was highly predictive of subsequent AMA events.
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