MedicalResearch.com Interview with:
Allan Garland, MD, MA
Co-Head, Section of Critical Care Medicine
Associate Professor of Medicine and Community Health Sciences
University of Maniitoba
820 Sherbrook St / GF-222
Winnipeg, Manitoba R3A 1R9
MedicalResearch.com: What are the main findings of the study?
Answer: Our study evaluated consequences of leaving the hospital against medical advice (AMA). It is a large, population-based analysis, that evaluated all hospitalizations from which patients were discharged alive, among all adults in the Canadian province of Manitoba over a 19 year period; this was over 1.9 million hospitalizations. Outcomes assessed were hospital readmission and death over 6 months after the event. Specifically, we compared these outcomes for those who left the hospital against medical advice, compared to those who remained in the hospital until their doctors felt it was safe to be discharged -- and these comparisons adjusted for a variety of patient and illness characteristics.
Among the 1.9 million hospitalizations, there were 21,417 that ended with the patients leaving against medical advice, this is 1.1% of the total. Without adjustment for other variables, leaving against medical advice was associated with double the rate of unscheduled
hospital readmission within 30 days (24.0 vs. 12.1%); after adjustment, the odds of unscheduled hospital readmission within 30 days was 3-fold higher for someone who left against medical advice compared to one who did not. After adjustment, the odds of death at 90 days were 2.51-fold higher for those who left against medical advice.
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