Date of Award

2021

Document Type

Dissertation

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Walter J. Jones

Second Advisor

Kit N. Simpson

Third Advisor

Mary Dooley

Abstract

Research indicates that as hospital costs increase and Emergency Room wait times grow, more patients leave facilities against medical advice at the detriment to their medical condition and higher risk for mortality (Reese, 2019). Discharges against medical advice (DAMA), in which a patient chooses to leave the hospital without physician approval, is a growing problem for patients and providers (Taqueti, 2007; Carrese, 2006). Patients who DAMA only represent 1-2% of hospital admissions; however, this small group is quite significant due to their high readmission and mortality rates (Lee et al., 2016). It is therefore important to understand characteristics of these patients and challenges associated with their readmittance to improve patient outcomes and minimize economic burden on the U.S. healthcare system (Lee et al., 2016; Reese, 2019). This retrospective analytic study reviewed the risk of readmissions of DAMA patients by analyzing hospital billing data of patients across Florida, Georgia, Kentucky, and Mississippi. Descriptive statistics, demographic characteristics, and diagnosis related data yielded insight on the risk of readmissions and the impact DAMA has upon patients’ health status upon being readmitted.

Rights

All rights reserved. Copyright is held by the author.

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