Lelieveld et al identified risk factors for an older adult being discharged against medical advice (DAMA). The authors are from Erasmus University, Mount Sinai Hospital, Weill Cornell Medical College, Hospital for Special Surgery, and Paracelsus Medical University in Salzburg.
Patient selection: age >= 65 years
The probability for DAMA in an adult >= 65 years is only about a quarter of that seen in a younger adult.
Risk factors for DAMA:
(1) male gender
(2) self-pay, Medicaid or poverty
(3) non-White ethnicity
(4) mental illness
Conditions associated with a low rate of DAMA:
(1) cancer
(2) orthopedics
(3) dementia
One hypothesis was that DAMA was related to poor communications between the patient and clinicians.
A history of previous DAMA or substance abuse did not appear to be included as variables.
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