What makes patients go against medical advice: Study

Washington D.C.: A new study has revealed the certain factors that are linked with a person's decision to leave the hospital against the advice of his or her care provider.

Also, some of these factors are more pronounced in older versus younger individuals. The findings may help healthcare providers address this growing problem.

Discharge against medical advice is linked with an increased risk of hospital readmission, higher morbidity and mortality, and increased costs. To examine the factors involved, a team led by Jashvant Poeran of the Icahn School of Medicine at Mount Sinai, analyzed national data on all US hospitalizations. They were especially interested in differences for patients aged 65 years compared with those aged 18-64 years.

Their analysis, which included more than 29 million hospital stays listed in the 2013 National Inpatient Sample, revealed that greater than 50,000 older adults in the hospital (out of 12 million people under hospital care overall) left the hospital against medical advice that year; however, older men and women were 4 times less likely to do so than people aged 18-64 years.

From 2003 to 2013, rates increased in those aged 18-64 from 1.44% to 1.78%, and in those aged 65 from 0.37% to 0.42%. In both age groups, men, people insured by Medicaid or those without health insurance, and individuals living with mental health concerns had the highest risks of leaving the hospital against medical advice.