Primary care companion to the Journal of clinical psychiatry
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Prim Care Companion J Clin Psychiatry · Jan 2010
Hospital admission for schizophrenia and discharge against medical advice in the United States.
Hospital discharge against medical advice may leave a patient at risk for adverse health outcomes and/or readmission, yet little is known regarding its occurrence, especially among patients with mental illness. The objective of this study was to discern the prevalence of, and predictive factors for, being discharged against medical advice among hospitalized patients with a primary diagnosis of schizophrenia. ⋯ Although the percentage of patients discharged against medical advice was small, the numeric magnitude on a nationwide basis was substantial. The adjusted mean length of stay for discharge against medical advice was significantly reduced, while cost per day was significantly higher. Discharge against medical advice represents a challenge to the provision of care for patients with schizophrenia and may contribute to increased use of primary and specialty outpatient services, rehospitalization rates, morbidity, and mortality.