Association of Hospital Discharge Against Medical Advice With Readmission and In-Hospital Mortality

Key Points Question What are hospital readmission and mortality outcomes after discharge against medical advice? Findings In this nationally representative, all-payer cohort study that included nearly 20 million hospital admissions, discharge against medical advice was associated with a 2.01 increased adjusted odds of 30-day all-cause readmission and a 0.80 decreased adjusted odds of 30-day in-hospital mortality compared with non–against medical advice discharge. Readmissions after discharge against medical advice accounted for more than 400 000 inpatient hospitalization days at a total cost of more than $800 million annually. Meaning Patients leaving against medical advice face higher odds of readmission; hospitals should consider targeted interventions and risk stratification to identify the highest-risk individuals among this vulnerable population.