Table 1.
Characteristics of Discharges Against Medical Advice and Planned Discharges
| Characteristic | All Patients (n = 84,080) |
Discharged AMA (n = 3,544) |
Planned Discharge (n = 80,536) |
p value |
|---|---|---|---|---|
| Age | 57.8 ± 17.0 | 48.7 ± 15.4 | 58.2 ± 17.0 | <0.001 |
| Male | 36,980 (44.0) | 2225 (62.8) | 34,755 (43.1) | <0.001 |
| Race | ||||
| White | 15,860 (18.9) | 625 (17.6) | 15,235 (18.9) | 0.06 |
| Black | 29,492 (35.1) | 1289 (36.4) | 28,203 (35.0) | 0.10 |
| Hispanic | 33,084 (39.3) | 1461 (41.2) | 31,623 (39.3) | 0.02 |
| Other/Unknown | 5,644 (6.7) | 169 (4.8) | 5475 (6.8) | <0.001 |
| Insurance | ||||
| Medicare | 31,640 (37.6) | 924 (26.1) | 30,716 (38.1) | <0.001 |
| Medicaid | 30,058 (35.7) | 2137 (60.3) | 27,921 (34.7) | <0.001 |
| Commercial | 21,695 (25.8) | 441 (12.4) | 21,254 (26.4) | <0.001 |
| Self | 685 (0.8) | 42 (1.2) | 643 (0.8) | 0.01 |
| History of substance abuse | 11,365 (13.5) | 1344 (37.9) | 10,021 (12.4) | <0.001 |
| History of psychiatric illness | 12,041 (14.3) | 924 (26.1) | 11,117 (13.8) | <0.001 |
| Charlson score | 1.79 ± 2.01 | 2.27 ± 2.53 | 1.77 ± 1.98 | <0.001 |
| # Elixhauser diagnoses | 2.26 ± 1.53 | 2.31 ± 1.63 | 2.26 ± 1.53 | 0.23 |
| Admission albumina | 3.95 ± 0.52 | 3.86 ± 0.65 | 3.95 ± 0.52 | <0.001 |
| Admission creatinineb | 1.0 (0.8 – 1.3) | 0.9 (0.7 – 1.3) | 1.0 (0.8 – 1.3) | <0.001 |
| LAPS scorec | 18.6 ± 14.7 | 19.5 ± 16.1 | 18.6 ± 14.6 | 0.13 |
| Diagnoses, No.(%) | All Patients (n = 84,080) |
Discharged AMA (n = 3544) |
Planned Discharge (n = 80,536) |
p value |
|---|---|---|---|---|
| Diagnoses associated with discharge AMAa | ||||
| Substance abuse | 136 (0.2) | 20 (0.6) | 116 (0.1) | <0.001 |
| Alcohol abuse | 1098 (1.3) | 248 (7.0) | 850 (1.1) | <0.001 |
| Medication poisoning | 881 (1.0) | 120 (3.4) | 761 (0.9) | <0.001 |
| Sickle Cell Crisis | 1998 (2.4) | 191 (5.4) | 1807 (2.2) | <0.001 |
| Human Immunodeficiency Virus | 1920 (2.3) | 267 (7.5) | 1653 (2.0) | <0.001 |
| Common discharge diagnosesb | ||||
| Congestive Heart Failure | 5501 (6.5) | 155 (4.4) | 5346 (6.6) | <0.001 |
| Chest pain | 7877 (9.4) | 263 (7.4) | 7614 (9.4) | <0.001 |
| Myocardial infarction | 2100 (2.5) | 62 (1.7) | 2038 (2.5) | 0.004 |
| Pneumonia | 3163 (3.8) | 75 (2.1) | 3088 (3.8) | <0.001 |
| Asthma/Chronic Obstructive Pulmonary Disease | 4847 (5.8) | 158 (4.5) | 4689 (5.8) | 0.00 |
| Other coronary disease | 5100 (6.1) | 155 (4.4) | 4945 (6.1) | <0.001 |
| Diabetes | 2943 (3.5) | 130 (3.7) | 2813 (3.5) | 0.58 |
| Arrythmia | 3742 (4.4) | 89 (2.5) | 3653 (4.5) | <0.001 |
| Sepsis | 614 (0.7) | 39 (1.1) | 575 (0.7) | 0.01 |
| Gastrointestinal bleeding | 1298 (1.5) | 49 (1.4) | 1249 (1.5) | 0.43 |
continuous variables reported as mean ± standard deviation, compared using t-tests with unequal variances
dichotomous variables reported as number (percent), compared using chi-squared tests
creatinine reported as median (inter-quartile range), compared using Wilcoxon rank-sum
a
13.8% of discharges did not have an albumin value available and were imputed as normal
b
0.8% of discharges did not have a creatinine value available and were imputed as normal
c
Laboratory-based Acute Physiology Score
a
The five diagnoses with highest proportion of discharge AMA
b
The ten most frequent diagnoses among medical inpatients reported in the U.S.