title: A model for predicting discharge against medical advice from adolescent residential treatment.
abstract: Characteristics of adolescents discharged from a psychiatric residential treatment center were examined to create a model for predicting patient discharge against medical advice (AMA). Subjects were 81 adolescents in two consecutive cohorts discharged between 1983 and mid-1988 (N = 49 and N = 32). In both groups 41 percent of the discharges were AMA. Logistic regression analysis found that an equation based on three factors--history of juvenile court involvement, unsupportive family attitude toward treatment, and diagnosis of conduct disorder--was 69 percent accurate in predicting discharge status in group 1 and 81 percent accurate in predicting discharge status in group 2. A positive correlation between rates of staff turnover and AMA discharge was noted.
authors.affiliation: Seattle Children's Home, Washington 98119.
authors.forename: A
authors.initials: A
authors.lastname: Vander Stoep
authors.forename: P
authors.initials: P
authors.lastname: Bohn
authors.forename: E
authors.initials: E
authors.lastname: Melville
mesh_terms: D000293:Adolescent; D000298:Adolescent, Hospitalized / Q000706:statistics & numerical data*; D005190:Family / Q000523:psychology*; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D007604:Juvenile Delinquency / Q000523:psychology; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D012307:Risk Factors; D012944:Social Support; D016312:Treatment Refusal; D014861:Washington