ArticleCureus2025
Shifts in Demographics and Characteristics Among Patients Leaving Against Medical Advice From Before, During, and After the COVID-19 Pandemic.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDischarges against medical advice (AMA) present a significant public health challenge and are associated with increased readmission and mortality rates. The COVID-19 pandemic altered the healthcare landscape regarding public trust in the United States, which may have impacted the demographic and clinical profile of patients with AMA discharges. The aim of this study is to identify potential changes in the demographics of AMA discharges before, during, and after the COVID-19 pandemic at a large academic medical center. Methods: This non-interventional retrospective cohort study included adult inpatients (n = 1,560) discharged AMA during three time periods: pre-COVID-19, during COVID-19, and post COVID-19. Demographic variables, the Social Deprivation Index (SDI), and comorbidities were analyzed via bivariate analysis and subsequently via multinomial logistic regression. Results: During COVID-19, Black patients made up a larger portion of AMA discharges compared to before the pandemic. The length of hospital stay before leaving AMA increased during and after the pandemic (43.1% discharged within two days before COVID-19, compared to 40.7% during the pandemic and 28.3% after the pandemic). In the post-COVID-19 period, AMA discharges were associated with higher SDI scores (M = 72.05 (SD = 28.67)) compared to before and during COVID-19 (M = 68.03 (SD = 29.43) before, 67.71 (SD = 29.87) during). Patients were also more likely to stay longer before leaving AMA than during COVID-19. Additionally, the frequency of AMA discharges originating from the ICU increased significantly following the resolution of the pandemic.
conclusionThe determinants of AMA discharges have a temporal association with the COVID-19 pandemic. Findings suggest that patients leaving AMA are now more likely to be socially disadvantaged, from minority backgrounds, to have longer hospital stays, and to be leaving directly from the ICU. Targeted interventions to improve patient trust and support in these populations are needed to reduce AMA discharges and improve outcomes.
Indexed as
Identifiers
What OpenQuestion holds
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.