Hospital - where they’ll wake you up to give you a sleeping pill.
Why do patients leave against medical advice?
21–30 of 85 posts
Re: Why do patients leave against medical advice?
#22I left on day 4 of 6 combatting a MRSA infection. I left on 12/31 because the hospital could not tell me if my current insurance (COBRA) would cover the bills for days 5/6. Absurd. Turns out I was right in my estimations that the course of IV would suffice and also that the remaining days would not be covered. I feel like I 'survived' the hospital system, not MRSA.
> I left on 12/31 because the hospital could not tell me if my current insurance (COBRA) would cover the bills for days 5/6. Absurd. For future reference, asking the hospital what your insurance covers will always result in a "we don't know" answer because they don't speak for your insurance. They can't risk saying "yes" when they aren't the ones deciding. In these cases, call the insurance company. The reps deal wit…
> In these cases, call the insurance company.
I did that once, they told me "we don't know because we don't know what the hospital will bill".
So I decided that I don't know if I'll pay..........
Re: Why do patients leave against medical advice?
#23The shockingly low priority hospitals give to patient sleep might be a factor that the authors missed.
Re: Why do patients leave against medical advice?
#24My father went through a crazy amount of medical care in a few short years. He checked himself out AMA twice. Once because the provider was an idiot and making him sicker. Another time so he could die at home instead of in the hospital where they couldn't really help him anyway.
Re: Why do patients leave against medical advice?
#25people want to be back in their own homes. i was in hospital a year ago (nhs, fractured ankle) and the guys in the whole ward i was on were literally desperate to get out of the place (which wasn't horrible, and i think the nhs is brilliant). it took me probably an extra week to get discharged that it needn't have done. but there is a lot of arse-covering going on.
> people want to be back in their own homes Seriously why are "bad food" and "noisy nurses" not on the list of reasons? People want to eat and sleep and if they feel like their acute medical problem is manageable I can see why they'd want to leave.
well, i sort of thought that those were implied by what i said (we all wanted to get away from the whole hospital vibe). but i have to say that all of the nurses in my extended stay were great, and not so noisy. a friend was working doing the catering there, and she said they did their best with limited resources - i had some ok meals.
as i say, i really appreciate the nhs, tho perhaps not the bureaucracy.
Re: Why do patients leave against medical advice?
#26I've witnessed several people AMA from hospitals. All of them were not being treated well for pain and even in cases where there were calls for psych staff to help - there was imo below minimal mental / emotional support given. In a couple of the cases the people were able to find better pain medicine on the street faster than they could even get a doctor to answer a nurses call to deny - and being able to find just…
Anesthesiologist here. Pain sucks. It’s notoriously hard to treat. Hard to measure. And most of our treatments for it have real, often life threatening, side effects.
I get no greater pleasure as a doctor as to when I get someone painfree. Luckily I have some tools, like nerve blocks, which help in certain cases but even that’s limited.
Pain just sucks.
Re: Why do patients leave against medical advice?
#27This paragraph caught my eye: > The financial burden is not imposed on the patient only; the healthcare system is also affected by the consequence of leaving against medical advice. Reports have shown that the cost of an average stay was USD 3716.00 for those patients who left as planned. However, patients who left against medical advice and were readmitted had an average bill of USD 10,761.56 for staying 4.7 days in…
Part of my job I build predictive models to identify individuals at high risk of 'readmission' (it impacts billing, hence why healthcare systems are interested). Conditional on an individual's history (e.g. do you have diabetes, other comorbidities, etc.), I haven't found much evidence that leaving against Dr advisement matters all that much for predicting readmission.
> I haven't found much evidence that leaving against Dr advisement matters all that much for predicting readmission
maybe cos they're dead
Re: Why do patients leave against medical advice?
#28people want to be back in their own homes. i was in hospital a year ago (nhs, fractured ankle) and the guys in the whole ward i was on were literally desperate to get out of the place (which wasn't horrible, and i think the nhs is brilliant). it took me probably an extra week to get discharged that it needn't have done. but there is a lot of arse-covering going on.
> people want to be back in their own homes Seriously why are "bad food" and "noisy nurses" not on the list of reasons? People want to eat and sleep and if they feel like their acute medical problem is manageable I can see why they'd want to leave.
Been in NHS hospital a few years ago, food was fine, nurses were great (if horribly overworked).
Re: Why do patients leave against medical advice?
#29Earlier quoted context omitted.
> I left on 12/31 because the hospital could not tell me if my current insurance (COBRA) would cover the bills for days 5/6. Absurd. For future reference, asking the hospital what your insurance covers will always result in a "we don't know" answer because they don't speak for your insurance. They can't risk saying "yes" when they aren't the ones deciding. In these cases, call the insurance company. The reps deal wit…
This is good advice, but I can just feel the egregious hold times, insufferable IVR (our choices have changed!), and explaining the same thing to 5 different people until you get an answer that winds up being incorrect but good luck proving that in Small Claims because smartphones are very good at preventing you from recording conversations for your own records. I understand the reasons why we structure our world usi…
>"…because smartphones are very good at preventing you from recording conversations for your own records."
If you don't want to deal with the plethora of scummy apps to record call, you can go old-fashion and buy a telephone pickup microphone[1] for $20.
[1] https://www.amazon.com/Olympus-TP-8-Telephone-Pick-up-Microp...
Re: Why do patients leave against medical advice?
#30Because the hospital is clearly an incredibly unhealthy place to be. A nightmare.
It's Walmart. Or a meat factory. Or a jiffy-lube. The cashier wants to stick a needle in you. The surgeon forgot to install your oil-filter.
And don't get me started on the staff. Most of the doctors I meet are just children with technical training. Mentally stunted. Sleep deprived. These are not the people you want fiddling with your health, or anything or anybody that you care about.