ArticleJournal of general internal medicine2025
Patients Discharged "Against Medical Advice" More than Once: A Cross-Sectional Descriptive Analysis of a Vulnerable Population.
Article in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed.
- Multiple electrolyte imbalances in hospitalized patients: a multimorbidity perspective from a large, retrospective cohort study.Annals of medicine · 2026Article
- Using group concept mapping to co-create a research agenda with the homeless community in Rhode Island.Research involvement and engagement · 2026Article
- Improving Equity at Premature Discharge: Reframing Discharge Against Medical Advice Using the Structural Competency Framework.Journal of general internal medicine · 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
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundPatients who have been discharged "against medical advice" (AMA) are at increased risk of morbidity and mortality, but there is little research about patients who have had more than one AMA discharge.
objectiveWe aimed to describe the socio-demographic and clinical characteristics of patients with more than one AMA discharge.
designWe conducted a cross-sectional, retrospective chart review of a sample of adult patients who were discharged AMA more than once between 2016 and 2021 and abstracted detailed characteristics of this sample. PATIENTS: A total of 81 patients were discharged AMA more than once during the study period. MAIN MEASURES: We reviewed demographics, health insurance, substance use and mental health diagnoses, psychiatric consultations, documentation of prior AMA discharges, admitting medical service, length of stay, number of hospitalizations during the study period, and readmission within 30 days of the first AMA discharge. We also noted the presence of relevant psychosocial stressors. KEY
resultsAmong 81 patients reviewed, the average age was 41 years (range 19-76). Most were unmarried (n = 72, 89%) and most had public insurance or were uninsured (n = 74, 91%). More than half (n = 52, 64%) had a readmission within 30 days. The average number of hospitalizations in the study period was 10 (range 2-47). These patients had a high burden of psychosocial stressors including financial stress (56, 69%), housing insecurity (n = 40, 49%), and grief or loss of social support (n = 20, 25%).
conclusionsPatients who have been discharged AMA more than once represent a vulnerable population with significant unmet needs.
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Registered trials
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.