Henry Brems, PhD

Discharging ‘before medically advised’ (BMA)—alternatively known as ‘against medical advice’—from an admission for an asthma exacerbation represents one of the strongest risk factors for 30-day readmission and other adverse outcomes. BMA discharges occur more commonly among racial minority and low-income populations, thus worsen existing health disparities among patients with asthma. Very little is known about what factors drive the excess readmission risk after a BMA discharge, but it may be related to the lower quality of outpatient care received after discharge. Both clinician- and patient-level factors likely contribute to the inferior post-discharge care and to the excess readmission risk. However, these factors have not been well characterized. To better understand and address the increased risk faced by this population, this proposal seeks to identify pertinent gaps in outpatient care as well as the clinician- and patient-level barriers that contribute to readmission risk in order to inform development of a tailored intervention to improve outcomes.

Funded by the American Lung Association’s Accelerator Program and ATS/CHEST Foundation Respiratory Health Equity Research Award