If you must leave early, make sure you and your doctor set up a treatment plan.

Don't get up: Leaving the hospital too soon sets you up for a return visit.

RODALE NEWS, EMMAUS, PA—Skipping out of the hospital before your doctor thinks you’re ready can increase your risk of being readmitted, or even dying, according to a review of studies published recently in Mayo Clinic Proceedings.

THE DETAILS: Researcher David Alfandre, MD, of the Department of Veterans Affairs National Center for Ethics searched a database of medical studies from 1970 to 2008 to determine how leaving the hospital against a doctor’s orders can affect patient health. One study found that asthma patients leaving the hospital against medical advice had a four times higher risk of going to the emergency room, and a three times greater risk of being readmitted to the hospital within a month. Another found that patients who left the hospital against medical advice faced a seven times greater risk of being readmitted for the same ailment within 15 days. Heart attack patients who leave the hospital early have a 40 percent higher risk of death or readmission for heart attack or unstable angina for up to 2 years. This comes at a financial cost, too: A patient readmitted after leaving against medical advice has a 55% higher price tag for his stay. Poorer people, younger people (especially men), those with Medicaid or no insurance, or people with substance-abuse problems are those most likely to leave the hospital before physicians recommend it.

WHAT IT MEANS: Health isn’t always the top priority of hospital patients. They may have a family to raise, bills to pay, or some other obligation. If you feel the need to check out before your scheduled release, here are some things to keep in mind:

•  Have a heart-to-heart with your doc. Usually no one’s thrilled at the idea of being in a hospital, but before you rip out your IV and bolt for the exit, you must talk to your doctor. If you really want to go, it’s your call, but you should get all the facts before you make a decision.

•  Discharge with a plan. If you are in a situation where you need to leave the hospital before your doctor thinks you’re ready, be sure to develop a treatment plan for outpatient care with doctors before you’re discharged.