Patient-Physician Sex Discordance and “Before Medically Advised” Discharge from Hospital: A Population-Based Retrospective Cohort Study

Patient-physician sex discordance (when patient sex does not match physician sex) has been associated with reduced clinical rapport and adverse outcomes including post-operative mortality and unplanned hospital readmission. It remains unknown whether patient-physician sex discordance is associated with “before medically advised” hospital discharge (BMA discharge; commonly known as discharge “against medical advice”). To evaluate whether patient-physician sex discordance is associated with BMA discharge. Retrospective cohort study using 15 years (2002–2017) of linked population-based administrative health data for all non-elective, non-obstetrical acute care hospitalizations from British Columbia, Canada. All individuals with eligible hospitalizations during study interval. Exposure: patient-physician sex discordance. Outcomes: BMA discharge (primary), 30-day hospital readmission or death (secondary). We identified 1,926,118 eligible index hospitalizations, 2.6