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. 1996 Oct;88(10):658–660.

Race and hospital discharge against medical advice.

E Moy 1, B A Bartman 1
PMCID: PMC2608118  PMID: 8918072

Abstract

This study examines the relationship between race and discharge against medical advice from hospitals. Data were taken from the 1990 National Hospital Discharge Survey, which provides national estimates of hospitalizations in short-stay hospitals. Discharges against medical advice by white, African-American, and other race patients were examined. In 1990, there were an estimated 241,911 discharges against medical advice, accounting for 0.92% of all live discharges. In bivariable analyses, African-American patients were 1.78 times more likely then white patients to be discharged against medical advice. This may reflect greater dissatisfaction with inpatient care by African-American patients and may expose them to additional risk for adverse medical outcomes. Optimization of the delivery of inpatient services to patients of all races requires addressing this inequity.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blendon R. J., Aiken L. H., Freeman H. E., Corey C. R. Access to medical care for black and white Americans. A matter of continuing concern. JAMA. 1989 Jan 13;261(2):278–281. [PubMed] [Google Scholar]
  2. Corley M. C., Link K. Men patients who leave a general hospital against medical advice: mortality rate within six months. J Stud Alcohol. 1981 Nov;42(11):1058–1061. doi: 10.15288/jsa.1981.42.1058. [DOI] [PubMed] [Google Scholar]
  3. Endicott P., Watson B. Interventions to improve the AMA-discharge rate for opiate-addicted patients. J Psychosoc Nurs Ment Health Serv. 1994 Aug;32(8):36–40. doi: 10.3928/0279-3695-19940801-14. [DOI] [PubMed] [Google Scholar]
  4. Jeffer E. K. Against medical advice: Part I, A review of the literature. Mil Med. 1993 Feb;158(2):69–73. [PubMed] [Google Scholar]
  5. Jeremiah J., O'Sullivan P., Stein M. D. Who leaves against medical advice? J Gen Intern Med. 1995 Jul;10(7):403–405. doi: 10.1007/BF02599843. [DOI] [PubMed] [Google Scholar]
  6. Jones A. A., Himmelstein D. U. Leaving a county hospital against medical advice. JAMA. 1979 Dec 21;242(25):2758–2758. [PubMed] [Google Scholar]
  7. LaVeist T. A. Beyond dummy variables and sample selection: what health services researchers ought to know about race as a variable. Health Serv Res. 1994 Apr;29(1):1–16. [PMC free article] [PubMed] [Google Scholar]
  8. Long J. P., Marin A. Profile of patients signing against medical advice. J Fam Pract. 1982 Sep;15(3):551–556. [PubMed] [Google Scholar]
  9. Schlauch R. W., Reich P., Kelly M. J. Leaving the hospital against medical advice. N Engl J Med. 1979 Jan 4;300(1):22–24. doi: 10.1056/NEJM197901043000106. [DOI] [PubMed] [Google Scholar]
  10. Temkin-Greener H., Winchell M. Medicaid beneficiaries under managed care: provider choice and satisfaction. Health Serv Res. 1991 Oct;26(4):509–529. [PMC free article] [PubMed] [Google Scholar]
  11. Torres C. G., Turner M. E., Harkess J. R., Istre G. R. Security measures for AIDS and HIV. Am J Public Health. 1991 Feb;81(2):210–211. doi: 10.2105/ajph.81.2.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Wylie C. M., Michelson R. B. Age contrasts in self-discharge from general hospitals. Hosp Formul. 1980 Apr;15(4):273, 276-7. [PubMed] [Google Scholar]

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