Patients who leave against medical advice cost 9 percent more upon return
Once considered a low-cost population that hospitals could do little about, heart patients who self-discharge against medical advice cost more overall when they almost inevitably boomerang back, suggests new research from the University of Maryland school of Pharmacy.
Researchers led by Eberechukwu Onukwugha, an assistant professor in the school's department of pharmaceutical health services research, analyzed the records of more than 347,000 heart patients who had been cared for at Maryland hospitals between 2000 and 2005, 20,000 of which had been readmitted to the same hospital for more heart care following their initial stay. The self-discharged patients ended up costing hospitals nearly 9 percent more in treatment expenses than patients who were formally discharged by a doctor, the authors found.
Patients leave hospitals against medical advice for many reasons, including wanting to see their own doctors, frustration with wait times or worry over job and child care issues. Substance abusers may also leave prematurely to get a fix, the team noted in its presentation this week during the International Society for Pharmacoeconomics and Outcomes Research meeting in Atlanta.
But through follow-up focus groups, the team learned that there are strategies to help cardiovascular disease patients complete their therapy, including the use of social workers and improved communication and cultural awareness, reports Medical News Today.