Stay-In Acute Hospital Against Medical Advice. Why Patient Refused Hospital Discharge

Published on 19 November 2023 at 22:45

What is an Acute Hospital?

Hospital or Acute Hospital means getting a brief treatment but in severe condition and after treatment patient can be discharged home or preferred discharge locations. The Center for Medicare and Medicaid Service (2023) describes an acute hospital that provides medical care, treatment, and related services for surgery for acute medical conditions, usually for short-term illnesses or conditions. Normally, hospital stays are two to three days unless a severe condition needs more time for treatment and recovery.

What are the common reasons why patients refuse to leave the acute hospital?

Common problematic reasons patients report such as:

  • not understanding their disease condition,
  • do not know how to manage their new condition when transitioning to home,
  • do not have a clear understanding of what to do next or follow up,
  • fear,
  • not having enough support at home or,
  • getting away from other financial responsibilities.

What will happen when a patient refuses to leave the acute hospital?

Clinicians or physicians will review the discharge plans and ensure they are complete and safe. Clinicians or physicians work with interdisciplinary or multidisciplinary teams. Doctors usually write or enter a discharge order once everything is cleared and medically safe.

The nurse will discharge the patient and report to the doctor and hospital management when the patient refuses to leave and becomes problematic. Hospital management will follow their policies and procedures for patients refusing to leave the hospital when medically cleared. Hospital professionals will review every report and will report to patient payors. Patients have the right to call in their respective insurances and can file their appeals and report their discharge dissatisfaction reasons. An example of appeal is through Medicare with contracted quality improvement organizations such as Livanta. For further understanding and considerations, hospital physicians and other healthcare providers practice medical decisions with applications of ethical principles. Local counties check and regulate the patient's safe discharge plan, and proper documentation is required to understand how safe discharge handling of patient cases is taken care of.

 

Resources and or References

CMS.gov. (2023). CMS data navigator glossary of terms. https://www.cms.gov/Research-Statistics-Data-and Systems/Research/ResearchGenInfo/Downloads/DataNav_Glossary_Alpha.pdf

Livanta. (2022). Livanta’s online appeal system. https://www.livantaqio.cms.gov/

 

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