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Leaving Against Medical Advice

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When Patients Leave Against Medical Advice

About 1-2% of all patients leave the hospital against medical advice. Patients who are male or have a psychiatric condition or substance abuse are more likely to leave against medical advice. Patients who leave against medical advice are more likely to be readmitted or die within 30 days of leaving the hospital.

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When Patients Leave Against Medical Advice

Watch this video of a (reenacted) patient encounter. Think about what the staff could do differently.
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Remember 3 Steps for Your AMA Patients

1) Meet with the patient as soon as you can to address their concerns
2) Compromise on a treatment plan
3) Avoid misleading statements about financial responsibility

What to Do When a Patient Leaves AMA

This is a slide show we put together to present information about leaving AMA.

Fact & Fiction for AMA Patients by MergeLab

Short power point on what to do when hospitalized patients leave AMA (Against Medical Advice)
 
Important!

Remember

Patients who leave AMA are at higher risk of readmission or death.

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Articles About AMA Patients

Financial Responsibility of Hospitalized Patients Who Left Against Medical Advice: Medical Urban Legend?
Gabrielle Schaefer, Vineet Arora, MD and John Schumann, MD describe their findings about the financial responsibility of patients who left against medical advice and physician beliefs and practices regarding this issue.
AHRQ Web M&M: Discharge Against Medical Advice, Commentary
Stephen W. Hwang, MD, PhD offers some useful advice for assessing decision-making capacity, arranging follow-up, and maintaining communication with patients who leave AMA.
Insurance companies refusing payment for patients who leave the emergency department against medical advice is a myth.
A recent study of 104 ED patients in a Chicago hospital found that noen were held financially liable for leaving AMA.
Leaving against medical advice (AMA): risk of 30-day mortality and hospital readmission.
Patients that left against medical advice were more likely to be back in the hospital or to die within 30 days of discharge.
"I'm going home": discharges against medical advice.
David J. Alfandre, MD, of the NYU School of Medicine discusses strategies for preventing discharge against medical advice and plans for managing treatment of patients who do leave against medical advice.

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--Gabrielle Schaefer MS3 and Vineet Arora MD MAPP

by

gabrielleschaefer

I am a third year medical student at the University of Chicago. I spent my summer researching patients that leave against medical advice.

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