Discharged against medical advice: causes and consequences.

Patients discharged against medical advice in a rural general hospital in Alberta were studied retrospectively. The rate of discharge against medical advice (AMA) was 1.4% and was found to be comparable to the rates for other rural and urban general hospitals in central Alberta. Fifty consecutive discharges AMA were compared with 50 randomly selected adult discharges by physician during the same period. Demographic, diagnostic, and therapeutic variables were compared, and the fate of patients discharged AMA after departure was studied. A diagnosis of substance abuse or psychiatric illness discriminated significantly between the groups and accounted for apparent differences in the demographic variables. Those discharged AMA stayed for a shorter time in hospital and were noncompliant while there.