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February 1963

Hospital Discharges Against Medical Advice: II. Outcome

Author Affiliations

Assistant Professor (Dr. Meyer, Dr. Daniels) and Associate Professor (Dr. Margolis), Department of Psychiatry, University of Chicago School of Medicine.

Arch Gen Psychiatry. 1963;8(2):131-138. doi:10.1001/archpsyc.1963.01720080021004

Introduction  This paper reports a follow-up study of patients discharged against medical advice from the psychiatric inpatient service of the University of Chicago Clinics. The 32 patients in the study group left the hospital over the 2-year period, Sept. 1, 1957, through Aug. 31, 1959. They and their families were contacted 18 to 36 months after discharge. The results, evaluations, and implications of these contacts will be presented and discussed.This follow-up study by us is the second phase of an investigation of the process of discharge against medical advice. Results of the first study1 suggested that patients who were admitted as emergency cases, and who were inadequately prepared for the hospitalization, were particularly likely to leave against medical advice (a.m.a.). These patients were acutely disturbed, lacked insight, were unable to communicate, and had little motivation for treatment. The a.m.a. departures were usually precipitated

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