Patients are increasingly leaving hospitals against medical advice
Research Activities, October 2009
The number of hospital stays that ended with patients leaving against the advice of medical staff increased from 264,000 cases to 368,000—a 39-percent increase—between 1997 and 2007, according to the Agency for Healthcare Research and Quality (AHRQ). For cases in which patients left against medical advice in 2007, AHRQ also found that:
- The top five reasons were chest pain with no determined cause (25,600); alcohol-related disorders (25,300); substance-related disorders (21,000); depression or other mood disorders (13,900); and diabetes with complications (12,500).
- Medicaid and Medicare patients each accounted for about 27 percent of cases and privately insured patients accounted for 19 percent. About 22 percent of the cases in 2007 involved uninsured patients.
- Men were roughly 1.5 times more likely to leave against medical advice than women.
- In the Northeast, patients left hospitals against medical advice at twice the rate of that of the rest of the country—2 per 1,000 people versus an average of 1 per 1,000 people in all other regions.
These findings are based on data in Hospitalizations in which Patients Leave the Hospital against Medical Advice (AMA), 2007. The report uses statistics from the 2007 Nationwide Inpatient Sample, a nationally representative database of inpatient stays in all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured. For more details on the report, go to http://www.hcup-us.ahrq.gov/reports/statbriefs/sb78.jsp.