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April 1970

Maximum Hospital Benefits vs Against Medical AdviceA Comparative Study

Author Affiliations

American Lake, Tacoma, Wash
From the Veterans Administration Hospital, American Lake, Tacoma, Wash.

Arch Gen Psychiatry. 1970;22(4):351-355. doi:10.1001/archpsyc.1970.01740280063011

IN studying the rising admission and discharge rate at the Veterans Administration Hospital, American Lake, it became apparent that a significant number of patients were leaving the hospital against medical advice. Searching for literature on this subject was not particularly fruitful, although several studies were found.1-3

Patients who enter the hospital for psychiatric treatment and shortly thereafter leave against medical advice present a considerable problem. This group constituted 14% of discharges at American Lake Veterans Hospital during 1965 and 1966 and has averaged 10% (9.35%) over the past eight years. The actual cost in money and in staff effort to admit a patient is significant. Time factors involved in the admission procedures were analyzed and reported by the California Commission on Staffing Standards for State Mental Hospitals.4 We took the standard time allowances for the intake procedures from the California

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