Kumar N - Using multivariate hierarchical logistic regression modeling, researcher determined the impact of discharge against medical advice on 30-day readmission rates and outcomes of readmission. They used the 2014 Nationwide Readmissions Database to identify index hospitalizations among patients aged > 18 years. They found that patients discharged against medical advice were younger than patients with routine discharge, with a higher proportion of males. Compared with routine discharge, discharge against medical advice was related to over twice the odds of all-cause unplanned 30-day readmission. There was a large variation in discharge rates (0% to 12.5%) against medical advice at the hospital level. Interventions against medical advice to reduce discharges, especially in hospitals with high rates of such discharges, could reduce the overall readmission burden in this challenging and high-risk patient population. Alcohol-related disorders were the most common cause of readmission after discharge against medical advice.