"We can very easily see that although only 5% of hospital stays are among patients who have no insurance, 19% of the people who leave against medical advice are uninsured," she said. "To me, that's the biggest finding here, and we wanted to draw attention to that."
"You can imagine the scenario," she added. "Once people start feeling better, they want to leave right away. And if someone is responsible financially for their [own] hospital stay, they're going to have a much different threshold for wanting to stick around, because they know everything that happens to them in the hospital they will be financially responsible for [themselves]."
Medicare and Medicaid Patients
Patients covered by Medicaid made up 20% of the inpatient stays but accounted for 31% of those who left against medical advice. Patients covered by Medicare made up 40% of the inpatient stays but only 29% of those who left against medical advice. And patients who had private insurance coverage made up 32% of the inpatient stays, but accounted for only 16% of those who left against medical advice.
According to published research, reasons other than fear of costs prompting patients to leave the hospital before they are ready for discharge include lack of home conveniences or lack of hospital room privacy or other amenities. Additionally, they may think they don't need to be in the hospital or don't want to wait for a physician to complete discharge orders.
An estimated 1% to 2% of all hospital admissions are said to leave against medical advice, although people with substance abuse history and who are younger are more likely to do so.