RT Book, Section
A1 Kirby, Ryan P.
A1 Kirby, Jessica J.
A1 Robinson, Richard Dean
A2 Reichman, Eric F.
SR Print(0)
ID 1159793272
T1 Against Medical Advice
T2 Reichman's Emergency Medicine Procedures, 3e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259861925
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1159793272
RD 2024/04/19
AB Patients  electing  to  leave  against  medical  advice  (AMA)  represent  a  growing  population  in  the  United  States  and  provide  unique  challenges  to  the  Emergency  Physician.1Discharge  AMA  is  defined  as  the  patient  leaving  before  the  Emergency  Physician  finishes  the  evaluation  and  establishes  the  disposition.2  It  is  estimated  that  1%  of  Emergency  Department  visits  result  in  a  discharge  AMA.3,4  The  prevalence  rate  of  leaving  AMA  varies  between  Emergency  Departments.5  Discharge  AMA  patients  often  present  again  within  a  few  days,  resulting  in  increased  costs  associated  with  repeat  testing  and  higher  acuity  therapeutic  interventions  due  to  worsening  of  their  condition.3  The  AMA  patient  has  an  increased  risk  of  repeated  admission,  increased  admission  length  of  stay,  increased  morbidity,  and  increased  mortality.2,6-17  This  chapter  provides  an  overview  of  the  legal  obligations  to  treat  and  elements  associated  with  the  refusal  of  care  and  discusses  special  populations  that  may  be  encountered.