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Supplementary materials: Discharges against medical advice and 30-day healthcare costs: an analysis of commercially insured adult

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posted on 2024-01-08, 17:20 authored by Eberechukwu Onukwugha, Aakash Bipin Gandhi, David Alfandre

These are peer-reviewed supplementary material for the article 'Discharges against medical advice and 30-day healthcare costs: an analysis of commercially insured adults' published in the Journal of Comparative Effectiveness Research.

  • Appendix Table 1. A comparison of standardized mean differences for baseline covariates between matched and unmatched samples.
  • Figure S1. Histogram of 30-day healthcare costs for the total matched sample.
  • Figure S2. Histogram of 30-day inpatient readmission costs for the total matched sample.
  • Figure S3. Histogram of 30-day emergency department visit costs for the total matched sample.
  • Figure S4. Histogram of 30-day physician office visit costs for the total matched sample.
  • Figure S5. Histogram of 30-day non-physician outpatient encounter costs for the total matched sample.
  • Figure S6. Histogram of 30-day prescription drug fill costs for the total matched sample.
  • Figure S7. Consort diagram displaying study inclusion and exclusion criteria for the study sample.

Summary: Aim: Prior literature detailing the consequences of a discharge against medical advice (DAMA) has not focused on costs. We examine costs following a DAMA. Materials & methods: This retrospective cohort study utilized the IQVIA PharMetrics® Plus database to identify adults hospitalized during 2007–2015. We compared 30-day postdischarge healthcare costs between matched DAMA and routinely discharged groups. Results: Thirty-day healthcare costs for the DAMA group were US$1078 (95% CI: US$434–1730) higher, driven by inpatient readmissions (US$979; 95% CI: US$415–1543) and emergency department visits (US$79; 95% CI: US$56–102). Costs due to prescription drug fills were lower in the DAMA group. Conclusion: A DAMA was associated with higher 30-day postdischarge healthcare costs compared with routine discharges.

Funding

The authors acknowledge the support of the University of Maryland, Baltimore, Institute for Clinical & Translational Research (ICTR) through the ICTR Voucher Program.

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