I left on day 4 of 6 combatting a MRSA infection. I left on 12/31 because the hospital could not tell me if my current insurance (COBRA) would cover the bills for days 5/6. Absurd. Turns out I was right in my estimations that the course of IV would suffice and also that the remaining days would not be covered. I feel like I 'survived' the hospital system, not MRSA.
I've witnessed several people AMA from hospitals.<p>All of them were not being treated well for pain and even in cases where there were calls for psych staff to help - there was imo below minimal mental / emotional support given.<p>In a couple of the cases the people were able to find better pain medicine on the street faster than they could even get a doctor to answer a nurses call to deny - and being able to find just one person who would listen or offer any other emotional support was better than what they got paying 10,000$ or whatever it is to stay in a luxurious beeping room.<p>I'm talking about people with real pain - not a junkie looking for a fix.<p>I believe these issues have been exasperated since 2019- it appears that most hospital staff is burn out and no longer fit for the job of handling stressed out, hurting people. 2 out of 3 hospitals around here have big signs all over the place stating they have zero tolerance for rude or abusive people.<p>This policy itself is abused, and it's led to an even worse power dynamic / class war that is making hospitals worse for care, and sending more people to illicit pain management solutions.<p>small data points. more does not equal all - ymmv.
I left AMA once because I was fine but the hospital wanted my perfect insurance in Yuma, Arizona where most of the patients are uninsured immigrants.<p>I understand that they need to money to survive but three weeks was just outrageous.
> Other reported reasons that contributed to a patient deciding to leave the hospital against medical advice include poor customer service, respect, and quality of care. This perception was determined majorly by the cultural background and the healthcare team.<p>I know a rural guy who was once damn near ready to start a fistfight to get his wife out of the local hospital AMA. He believed they weren't qualified or equipped to actually give her proper care and were basically just stalling with useless treatments. And, at least as she tells the story, he was absolutely fucking right to drive her down the highway to a hospital in the nearest "real" city. I guess word gets around when the only hospital within 25 miles has a habit of falling back on explanations like "it's just heartburn; the next round of antacids will definitely fix it".
This paragraph caught my eye:<p>> The financial burden is not imposed on the patient only; the healthcare system is also affected by the consequence of leaving against medical advice. Reports have shown that the cost of an average stay was USD 3716.00 for those patients who left as planned. However, patients who left against medical advice and were readmitted had an average bill of USD 10,761.56 for staying 4.7 days in the hospital upon readmission.<p>This makes me laugh. As if medical care in the USA isn't already ridiculously inflated.<p>> Perhaps the most effective way to decrease discharge AMA is through changing existing policies and/or implementing new policies. Historically, governmental policies, incentivizing or penalizing, have dramatically driven substantial changes in the medical system. For example, different healthcare policies/programs have led to improved healthcare access in non-urban areas. Another example is the change of practitioner compensation from traditional fee-for-service models to bundled-payment models that resulted in a better quality of patient experience [51]. Therefore, implementing a lower rate of discharge AMA in hospital metrics, for example, will incentivize hospitals to further invest in mitigating discharge AMA.<p>We absolutely shouldn't penalize people who leave a for-profit business for not getting the service they desire. Also changing to fee-for-service would help people do a cost-benefit on their medical issues. If we are going to live in a capitalism world, then let hospitals compete for your money.
TIL Ishikawa fishbone root cause analysis<p><a href="https://en.wikipedia.org/wiki/Ishikawa_diagram" rel="nofollow noreferrer">https://en.wikipedia.org/wiki/Ishikawa_diagram</a><p>Of course I've seen them before but was struck by the interesting name.
My father went through a crazy amount of medical care in a few short years. He checked himself out AMA twice. Once because the provider was an idiot and making him sicker. Another time so he could die at home instead of in the hospital where they couldn't really help him anyway.
My dad had a heart-related scare, but we left the hospital after waiting 10 hours and not being seen (we were checked in an triaged, but that was it). Thank goodness I had prepared multiple meals + brought water but we did not expect that long of a wait, especially for something heart related.<p>After all that time, it just felt less risky to go home and get some baby aspirin. They made us sign a waiver as we left.
people want to be back in their own homes. i was in hospital a year ago (nhs, fractured ankle) and the guys in the whole ward i was on were literally desperate to get out of the place (which wasn't horrible, and i think the nhs is brilliant). it took me probably an extra week to get discharged that it needn't have done. but there is a lot of arse-covering going on.
My five-hour Atrial fibrillation didn't convert until I left the hospital ER. The hospital was so stressful with constant beeps, patients moaning or crying, staff disappearing, that it was obviously keeping my pulse high despite meds.<p>I honestly felt like my job was to comfort the harried staff.<p>When I got my meds the next day, they only cost $0 because I used up my entire $6k deductible that night.
When I wanted to get my teeth straightened the first doctor suggested pulling two teeth to make room. I walked out quickly. The second doctor confirmed the suspicion that this would have been completely unnecessary.
My ~18 month old son is medically complex, and his pediatricians send him to the ER basically every other week. ER docs run a bunch of tests, shrug and say LGTM and send us home. The hospital is an hour away, and they never get any closer to figuring out what the problem is (just follow up with X specialist in Y months). My wife and I are sick of it, but we’re worried that if we don’t take him in when they tell us to that CPS might get involved. So off we go, wash rinse repeat.<p>All of that to say, if someone wants to leave early, I get it.
Because you realize the Drs. are proxies for hospitals and err on the side of hospital stay despite quality of life balance.<p>They follow guardrails closely aligned with insurance and liability too. Unfortunately.
Because the hospital is clearly an incredibly unhealthy place to be. A nightmare.<p>It's Walmart. Or a meat factory. Or a jiffy-lube. The cashier wants to stick a needle in you. The surgeon forgot to install your oil-filter.<p>And don't get me started on the staff. Most of the doctors I meet are just children with technical training. Mentally stunted. Sleep deprived. These are not the people you want fiddling with your health, or anything or anybody that you care about.
I was recovering from insomnia and slipped on a spilled drink in the night. I had thirteen stitches from my head hitting a table. When I came to, I had an orderly follow me down the hall, trying to convince me to stay as I might have a concussion. I called a cab (pre-Uber, at least for me) and went home. I just hate hospitals.<p>Was it stupid? Probably. Though I’d probably do it again.