Stephen Hwang and colleagues prospectively studied 97 consecutive patients who left the general medicine service of a Toronto teaching hospital AMA. Each patient was matched according to age, sex and primary diagnosis with a control patient who was discharged routinely. The authors report that patients who left hospital AMA were much more likely to be readmitted (21% v. 3%) and that readmissions occurred at an accelerated pace in the first 15 days.
The authors state that given there are more than 20 000 discharges AMA in Canada every year, the problem has the potential to have a serious effect on patients and the health system.
p. 417 What happens to patients who leave hospital against medical advice? -- S.W. Hwang et al
Canadian Medical Association Journal