Signouts against medical advice from a coronary care unit

Abstract

Twenty-nine patients who were admitted to a Coronary Care Unit (CCU) but who subsequently discharged themselves against medical advice (AMA) were matched with a group of control patients who were admitted to the same unit but who remained in the hospital for the entire course of their treatment. The two groups were then compared on the basis of sociodemographic, medical, behavioral, and psychiatric variables. Results were that the AMA group differed significantly from the control group in a number of factors including age, number of previous AMA signouts, severity of medical problems, and self-reports of alcoholism and emotional difficulties. The relationship of these findings to the AMA behavior is discussed and intervention strategies are suggested.