Decision to Admit
Decisions to Admit to the Hospital
You should play an active role in your own health care, be involved in decisions about, and agree with all aspects of your medical care. Questions you should consider asking if you require admission to a hospital include the following:
• Why do I need admission?
• What is my diagnosis?
• If the doctor does not know, what are the possible things I might have?
• What are the chances I might have any of the problems on the list?
• How long might I need to be admitted?
• Will my insurance pay for the admission?
• What workup or treatments will I need?
• Are there any risks to my admission?
• What are the risks if I don’t agree to be admitted?
• Are there any other options?
• Was my doctor contacted?
The following factors should be considered in a decision to admit you to a hospital:
• Your medical problem
• The history relating to your medical problem
• Your past medical history
• The possibility your medical concern could be serious
• Other medical problems that may complicate or cause the current problem to get worse
• Abnormal tests, ECGs, lab work, x-rays
• Abnormal physical exam
• Unstable vital signs—temperature, heart rate, blood pressure, oxygen concentration in your blood
• Diagnosis—what you have
• Prognosis—what most likely will happen because of your conditions and in what time frame
• Whether you require care that cannot be given as an outpatient (someone treated at the hospital but not admitted as a patient)
• Whether you require diagnostic testing that cannot be performed as an outpatient
• Whether you require the immediate service of a consultant
• The presence or absence of a private doctor
• The availability of close follow-up, if required
• Outpatient care fails to improve your condition
• You need surgery
• Family members or friends relate other details to the admitting doctor or emergency department physician
• Insurance issues
When you don’t want to be admitted
People who are mentally competent may refuse to be admitted for any reason. Before you decide, however, get the best information available. Be aware that you may be putting yourself at significant risk of death or disability by not following the admitting doctor’s advice.
• Ask why you need to be admitted and discuss the risks and benefits of admission versus going home.
• Ask to speak with your doctor.
• If you refuse to be admitted, you may be asked to sign out against medical advice (AMA).
• If you sign out against medical advice, your insurance company may not cover the costs for that visit.
• If you sign out against medical advice, ask for the best advice to care for your problem.
Your Rights as a Patient
Your rights are listed in the hospital’s Patient’s Bill of Rights. If these rights are not given to you or posted, ask for them.
• You have the right to considerate and respectful care.
• You have the right to complete information regarding your diagnosis, treatment, and expected recovery in terms that you can understand.
• You have a right to know the name of the doctors and all health care personnel who provide care for you.
• You should be provided with sufficient information about the benefits, risks, and other alternative treatments or procedures to be able to give informed consent for any procedure performed on you.
• You have the right to refuse treatment and to be informed of the possible medical consequences of doing so.
• You have the right to privacy—your doctors or health care providers cannot talk to anyone about your medical care without your permission.
• You must be given a medical screening exam and be evaluated for care whenever you go to a hospital. The severity of your problem will determine your level of treatment after this exam.
• If you need to be transferred to another facility, the information on why you require transfer must be given to you.
• The hospital you are being transferred to must have accepted you prior to transfer.
• You have a right to know if the hospital has any relationship to other health care or educational institutions and if this relationship affects your care.
• You have the right to know if any experimentation will be performed on you, if it will affect your care, and that you have the right to refuse participation, at any time, for any reason.
• You have the right to reasonable continuing care once discharged.
• You should be informed of appointment times, the location for follow-up, and who will provide follow-up care.
• You have the right to be informed about your continuing health care requirements after you are discharged.
• You have the right to examine and receive an explanation of your bill.
• You have a right to know what hospital rules and regulations apply to your conduct.