Dramatic Increase Seen in Patients Leaving Hospitals AMA

Cheryl Clark, for HealthLeaders Media , March 11, 2011

"Patients leave AMA for a variety of reasons. When asked, they most commonly cite family problems or emergencies; personal or financial obligations; feeling bored, fed up, or well enough to leave; or dissatisfaction with their treatment. Although many patients who discharge themselves AMA have substance abuse problems, few of them attribute their decision to leave to their addiction," Hwang wrote.

The fastest increase in discharges was the category of patients who went to follow-on care. In that category, the percentage discharged to home health care services grew by 69% in this period. That equated to 1.6 million discharges. Discharges to nursing homes and long-term care increased by 35%, or by 1.33 million discharges.

The number of discharges for in-hospital deaths declined 5% and discharges (transfers) to another short-term hospital rose 4%.

In 2008, the lion's share of discharges from U.S. hospitals involved patients who had routine discharges to their homes without closely supervised follow up healthcare. That category amounted to 72% of 39.9 million discharges.

The second largest category of discharges was to long-term care and other facilities, 13%. The third was to home health care services, 10%. In-hospital deaths and discharge to another short-term hospital were each 2% of discharges.

The AHRQ statistics may be found here.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.

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