Discharge against medical advice (AMA) from an acute care private psychiatric hospital

Abstract

Discharge from psychiatric hospitals against medical advice (AMA) is noncompliance with a physician's treatment regimen. Forty-one patients (26 male, 15 female) discharged AMA from a 32-bed proprietary acute care psychiatric hospital were matched by sex to 41 regularly discharged patients. Data that pertained to account status, marital status, race, month of admission, day of week of admission, time of admission, day of week of discharge, time of discharge, length of stay, religion, diagnosis, employment status, presence of prior psychiatric treatment, attending physician, hospital census, and adolescent census at time of admission were analyzed by Student's t-test, Chi-square, and Pearson correlation coefficients. Significant differences were found for length of stay (p less than .01), time of discharge (p less than .002), presence of prior psychiatric treatment (p less than .0005), and attending physician (p less than .02). Age and length of stay for the regularly discharged group were correlated (r = .47; p less than .001). The failure of this study to support much prior research may be related to differences in hospital setting, client population, and therapist variables.