October 1983

Differences Among Clinicians in the Decision to Admit

Author Affiliations

From the Department of Psychiatry, Harvard Medical School, Boston (Drs Apsler and Bassuk); The Cambridge (Mass) Hospital (Dr Apsler); and the Beth Israel Hospital, Boston (Dr Bassuk).

Arch Gen Psychiatry. 1983;40(10):1133-1137. doi:10.1001/archpsyc.1983.01790090095015

• Despite considerable efforts by researchers and clinicians to elucidate the nature of the decision to admit patients for psychiatric treatment, they disagree about the criteria for hospitalization and have made little progress understanding the decision-making process. This study further investigated factors influencing the decision to admit by incorporating two unusual (for this area) features: (1) use of a multivariate analysis and (2) examination of individual differences among clinicians. The results showed both strong similarities and differences in the criteria used by individual clinicians. For each caretaker, a relatively small list of criteria was developed. Taken together, these criteria correctly classified 90% of the patients (96% of nonhospitalized and 60% of hospitalized patients) in a large, urban, general-hospital emergency room.