ArticleBMJ open2023
Hospital readmissions and mortality following discharge against medical advice: a five-year retrospective, population-based cohort study in Veneto region, Northeast Italy.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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Who cites it
3 citing papers in PubMed.
- A comparative evaluation of time-series models for forecasting inpatient deaths and discharges against medical advice.Scientific reports · 2026Article
- Factors Influencing Patient Decisions to Discharge Against Medical Advice from Hospital Emergency: Insights From a Saudi Tertiary Hospital.Journal of patient experience · 2025Article
- Discharge against medical advice in pediatrics: a 10-year retrospective analysis in a tertiary care center.Annals of Saudi medicineArticle
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of this study was to examine the odds of readmission and mortality after discharge against medical advice (DAMA) in the Veneto region of Northeast Italy, drawing on data from the regional archives of emergency department records and hospital discharge records.
designA retrospective cohort study.
settingHospital discharges, Veneto region, Italy.
participantsAll patients discharged after being admitted to a public or accredited private hospital between January 2016 and 31 January 2021 in the Veneto region were considered. A total of 3 574 124 index discharges were examined for inclusion in the analysis. PRIMARY AND SECONDARY OUTCOME MEASURES: Readmission and overall mortality at 30 days after the index discharge against admission.
resultsIn our cohort, 7.6‰ of patients left hospital against their doctor's advice (n=19 272). These DAMA patients were more likely to be younger (mean age: 45.5 vs 55.0), foreign (22.1% vs 9.1%). The adjusted odds of readmission after DAMA was 2.76 (CI 95% 2.62-2.90) at 30 days (9.5% DAMA vs 4.6% not-DAMA), and the highest readmission rate was recorded in the first 24 hours after the index discharge. Mortality was higher for DAMA patients after adjusting for patient-level and hospital-level characteristics (with adjusted ORs of 1.40 for in-hospital mortality and 1.48 for overall mortality).
conclusionsThe present study shows that DAMA patients are more likely to die and to need hospital readmission than patients discharged by their doctors. DAMA patients should be more committed to a proactive and diligent postdischarge care.
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