Leaving against Medical Advice Associated with Increased Mortality, Readmission

Patients who leave the hospital against medical advice have higher rates of mortality and readmission, reports a study published online August 26, 2013, in the Canadian Medical Association Journal. The researchers evaluated 30-day hospital readmission and all-cause 90-day mortality for almost 2 million adult patients who were admitted to a Canadian hospital and discharged alive from April 1990 to February 2009 and found that 1.1% left that hospital against medical advice. When compared with patients who stayed in the hospital until discharge was recommended, those who left against medical advice were two and a half times more likely to die within 90 days and three times more likely to be readmitted to the hospital within 30 days. For both mortality and hospital readmission, the elevated rates among patients who left against medical advice started out high and then declined but remained significantly elevated for 180 days.