Race and hospital discharge against medical advice.

This study examines the relationship between race and discharge against medical advice from hospitals. Data were taken from the 1990 National Hospital Discharge Survey, which provides national estimates of hospitalizations in short-stay hospitals. Discharges against medical advice by white, African-American, and other race patients were examined. In 1990, there were an estimated 241,911 discharges against medical advice, accounting for 0.92% of all live discharges. In bivariable analyses, African-American patients were 1.78 times more likely then white patients to be discharged against medical advice. This may reflect greater dissatisfaction with inpatient care by African-American patients and may expose them to additional risk for adverse medical outcomes. Optimization of the delivery of inpatient services to patients of all races requires addressing this inequity.