Leaving hospital against medical advice (AMA) is common
among people who use illicit drugs (PWUD) and is associated with severe
health-related harms and costs. However, little is known about the prevalence
of and factors associated with leaving AMA among PWUD.
Data were collected through two Canadian prospective cohort
studies involving PWUD between September 2005 and July 2011 and linked to a
hospital admission/discharge database. Bivariable and multivariable generalized
estimating equations were used to examine factors associated with leaving
hospital AMA among PWUD who were hospitalized.
Among 488 participants who experienced at least one
hospitalization, 212 (43.4%) left the hospital AMA at least once during the
study period. In multivariable analyses, factors positively and significantly
associated with leaving hospital AMA included: unstable employment; recent incarceration; ≥ daily heroin injection; and
younger age per year younger.
We found a substantial proportion of PWUD in this setting
left hospital AMA and that various markers of risk and vulnerability were
associated with this phenomenon. Our findings highlight the need to address
substance abuse issues early following hospital admission. These findings
further suggest a need to develop novel interventions to minimize PWUD leaving
hospital prematurely.
Full article
at:
By:
Lianping Ti, M-J Milloy, Ryan McNeil, Sabina Dobrer, Kanna
Hayashi, Evan Wood, Thomas Kerr
British Columbia Centre for
Excellence in HIV/AIDS, St. Paul’s Hospital, 1081 Burrard Street, Vancouver,
BC, Canada V6Z 1Y6
Lianping Ti, M-J Milloy, Kanna Hayashi, Evan Wood, Thomas
Kerr
Department of Medicine,
University of British Columbia, 2775 Laurel Street, Vancouver, BC, Canada V5Z
1M9
Jane Buxton
School of Population and Public
Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada
V6T 1Z3
Jane Buxton
British Columbia Centre for
Disease Control, 655 West 12th Avenue, Vancouver, BC, Canada V5Z 4R4
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