More Medicare patients leaving hospitals against medical advice

The rate of Medicare enrollees leaving acute care hospitals against medical advice increased 46% between 2006 and 2023, from 0.68% to 0.99% of discharges, according to a report from HHS’ Office of Inspector General. 

The COVID-19 pandemic saw a spike of Medicare patients leaving hospitals against medical advice, with the AMA rate reaching 1.17%, according to the OIG report. 

During this 17-year period, when patients left AMA, they were more than twice as likely to be readmitted or die within 30 days, compared to Medicare enrollees discharged home. 

Additionally, “enrollees who leave AMA were more likely to have poor health outcomes, which raises Medicare costs in the future,” the report said. 

A separate study, conducted by researchers at Columbus-based Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, published in June, found a similar result. 

About 1% to 2% of inpatient hospitalizations resulted in AMA discharges — and these patients resulted in more than $800 million in annual associated healthcare costs. 

The OIG also found Medicare enrollees with a mental or behavioral health condition were more than twice as likely to leave AMA compared to other diagnoses and conditions. 

The growth rate of patients leaving hospitals against medical advice occurred across the board, and was not isolated to a hospital type, enrollee group or medical condition.

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