Data access has been approved for a project to evaluate whether specific clinical services (e.g., early outpatient prescription medication fills, early outpatient clinician follow-up, early return to hospital) can reduce the risk of harm after a ‘before medically advised’ (BMA) departure from hospital.
Each year, about 530,000 people in Canada and the United States leave hospital before completing the in-patient medical treatment recommended by their doctors. This is known as a patient-initiated or BMA discharge. Relative to routine physician-advised discharge, BMA discharges are associated with increased risks for subsequent emergency department (ED) visits, hospital readmissions, drug overdoses and death.
Dr. John A Staples, a General Internal Medicine physician and University of British Columbia (UBC) Clinical Associate Professor, is leading the research team. The team includes Dr Hiten Naik, a UBC early career researcher supported by a CIHR Postdoctoral research fellowship grant. The team is currently applying for operational research grant funding to complete the study.
“Standardized care pathways aren't typically available for patients who initiate a BMA discharge,” says Dr. Staples. “We hope that our work will inform the design and delivery of programs to protect these vulnerable and often marginalized patients.”
The team will analyze linked and deidentified population-based individual-level longitudinal administrative health data on all BC residents with at least one hospitalization between 2002 to 2025. The project will examine between-hospital differences in the risk of BMA discharge and in the risk of specific harms after BMA discharge (i.e., illicit drug overdose, ED visits, hospital readmissions, all-cause mortality). Researchers will also evaluate whether the receipt of specific clinical services (e.g., early outpatient prescription medication fills, early outpatient clinician follow-up, early return to hospital) are associated with a reduced risk of harm after BMA discharge.
PopData provided the research team with guidance and support throughout the Data Access Request process.
