Letter to the Editor

Discharge against Medical Advice

Authors: Gururaj J. Kolar, MD, Eric D. Valder, DO


To the Editor: Discharge against medical advice (AMA) is a process by which a patient chooses to leave the hospital before a physician’s recommended discharge. Leaving AMA may expose a patient to the risk of an inadequately treated medical problem and possible readmission. Patients discharged AMA are at elevated risk in terms of morbidity and mortality.1 Understanding why patients choose to leave the hospital AMA is important to identify so that we can intervene earlier to prevent this from happening.

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1. Alfandre DJ. "I'm going home": discharges against medical advice. Mayo Clin Proc 2009;84:255–260. 2. Wigder HN, Propp DA, Leslie K, et al. Insurance companies refusing payment for patients who leave the emergency department against medical advice is a myth. Ann Emerg Med 2010;55:393. 3. Schaefer GR, Matus H, Schumann JH, et al. Financial responsibility of hospitalized patients who left against medical advice: medical urban legend? J Gen Intern Med 2012;27:825–830.