Ethnicity, Poverty Are Risk Factors for Elders Being Discharged Against Medical Advice — Physician’s First Watch
Ethnicity, Poverty Are Risk Factors for Elders Being Discharged Against Medical Advice
By Kelly Young
Edited by Susan Sadoughi, MD
Race, ethnicity, and poverty are associated with increased risk for elderly inpatients being discharged against physicians' recommendations, a study in the Journal of the American Geriatrics Society finds.
Using a database of 29 million U.S. inpatient admissions, researchers tracked discharge against medical advice (DAMA) from 2003 to 2013. The percentage of people aged 65 and older discharged against medical advice was only a quarter of that of younger patients in 2013 (0.42% vs. 1.78%), but rates increased during the study.
Among seniors, patients with black, Hispanic, or Asian/Pacific Islander heritage had significantly higher DAMA risk, relative to white patients. The authors write that communication barriers and lower education levels could play a role in these higher rates. Elders residing in zip codes in the bottom half of median income also had elevated risk.
Risk factors affecting all ages included male sex, having Medicaid or no insurance, being treated in an urban nonteaching hospital, and mental health hospitalization.