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Patients who leave the emergency department against medical advice (AMA) are widely believed to pose both a medical–legal risk to the ED staff and a potential health risk to themselves. These authors retrospectively evaluated 30-day outcomes of patients who left AMA from an urban academic ED.
Of 31,252 adult patients who presented during a 1-year period, 3% left AMA, 9% left without being seen, 28% were admitted, and 60% were discharged. During the 30 days after the index visit or hospital discharge, patients who left AMA had significantly higher rates of emergent hospitalization and return ED visits at the study hospital compared with the other three groups. Patients who left AMA were significantly more likely to be uninsured or covered by …