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Against‐Medical‐Advice Discharges from the Hospital

Optimizing Prevention and Management to Promote High Quality, Patient-Centered Care

  • Book
  • © 2018

Overview

Editors:
  1. David Alfandre

    1. VHA National Center for Ethics in Health Care, Department of Veterans Affairs, NYU School of Medicine, New York, USA

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  • First-of-its-kind text addressing the problem of against medical advice discharges in hospital-based healthcare
  • Provides a comprehensive, multidisciplinary overview of a significant health care quality problem
  • Addresses the legal, ethical, and institutional aspects of the problem as well as provides a framework for best practices for varied clinical disciplines including emergency medicine, pediatrics, psychiatry, hospital medicine, and nursing

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Table of contents (11 chapters)

  1. Front Matter

    Pages i-xii
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  2. Ethical, Legal, and Empirical Considerations

    1. Front Matter

      Pages 1-1
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    2. Introduction

      • David Alfandre
      Pages 3-9

    3. Discharges Against Medical Advice: Prevalence, Predictors, and Populations

      • Madhuram Nagarajan, Ada Ibe Offurum, Mangla Gulati, Eberechukwu Onukwugha
      Pages 11-29

    4. Legal Considerations of Patient Refusals of Treatment Against Medical Advice

      • Arthur R. Derse
      Pages 31-40

    5. Ethical Considerations in Against Medical Advice Discharges: Value Conflicts Over Patient Autonomy and Best Interests

      • Jeffrey T. Berger, David Alfandre
      Pages 41-51

    6. Reframing the Phenomenon of Discharges Against Medical Advice: A Sociologist’s Perspective

      • Helen-Maria Lekas
      Pages 53-71

    7. Social Justice and the Ethics of Care: A Nursing Perspective

      • Jamie L. Shirley
      Pages 73-81

  3. Preventing and Managing Against Medical Advice Discharges Across the Spectrum of Care

    1. Front Matter

      Pages 83-83
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    2. Bedside Management of Discharges Against Medical Advice

      • Holly Fleming, David S. Olson Jr., David Alfandre, Cynthia Geppert
      Pages 85-105

    3. Against Medical Advice Discharges from the Emergency Department

      • Jay M. Brenner, Thomas E. Robey
      Pages 107-123

    4. To Thy Own Self Be True: Contributions from Consultation-Liaison Psychiatry

      • Nicole Allen, Philip R. Muskin
      Pages 125-141

    5. Against Medical Advice Discharges: Pediatric Considerations

      • Armand H. Matheny Antommaria
      Pages 143-157

    6. Against Medical Advice Discharges: Considerations in the Psychiatric Population

      • Cynthia Geppert
      Pages 159-176

  4. Back Matter

    Pages 177-181
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Keywords

About this book

This first-of-its-kind text provides a multidisciplinary overview of a significant problem in hospital-based healthcare:  patients who decline inpatient medical care and leave the hospital against medical advice (AMA).   Compared to standard hospital discharges, AMA discharges are associated with worse health and health services outcomes.   Patients discharged AMA have been found to have disproportionately higher rates of substance use, psychiatric illness, and report stigmatization and reduced access to care.  By providing a far reaching examination of AMA discharges for a wide academic and clinical audience, the book serves as a reference for clinical care, research, and the development of professional guidelines and institutional policy.  The book provides both a broad overview of AMA discharges with chapters on the epidemiology, ethical and legal aspects, as well as social science perspectives.  For clinicians in the disciplines of hospital medicine, pediatrics, emergency medicine, nursing, and psychiatry, the book also provides a patient-centered analysis of the problem, case-based discussions, and a discussion of best practices.  This comprehensive review of AMA discharges and health care quality will interest physicians and other health care professionals, social workers, hospital administrators, quality and risk managers,  clinician-educators,  and health services researchers.

Reviews

“This is a valuable and well-timed contribution to the clinical literature. Considering the frequency and clinical significance of AMA discharges, this book should be a common feature of both personal and institutional medical libraries. Clinicians may be most motivated to read it for the frank discussions of liability and documentation.” (Michelle Bach, Doody's Book Reviews, August, 2018)

Editors and Affiliations

  • VHA National Center for Ethics in Health Care, Department of Veterans Affairs, NYU School of Medicine, New York, USA

    David Alfandre

About the editor

David Alfandre, MD, MSPH

VHA National Center for Ethics in Health Care

US Department of Veterans Affairs

Associate Professor of Medicine and Population Health

NYU School of Medicine

New York, NY, USA

Bibliographic Information

  • Book Title: Against‐Medical‐Advice Discharges from the Hospital

  • Book Subtitle: Optimizing Prevention and Management to Promote High Quality, Patient-Centered Care

  • Editors: David Alfandre

  • DOI: https://doi.org/10.1007/978-3-319-75130-6

  • Publisher: Springer Cham

  • eBook Packages: Medicine, Medicine (R0)

  • Copyright Information: Springer International Publishing AG, part of Springer Nature 2018

  • Hardcover ISBN: 978-3-319-75129-0Published: 28 May 2018

  • Softcover ISBN: 978-3-030-09155-2Published: 22 December 2018

  • eBook ISBN: 978-3-319-75130-6Published: 17 May 2018

  • Edition Number: 1

  • Number of Pages: XII, 181

  • Number of Illustrations: 2 b/w illustrations, 2 illustrations in colour

  • Topics: General Practice / Family Medicine, Cardiology, Surgery, Pediatrics

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