Original article

Korean Journal of Schizophrenia Research 2009;12(2):69-75.

정신과 보호병동에서 거역퇴원 환자의 특성

Seong-Yun Jeong, MD, Seung-Bum Kang, MD, Sun-Kyung Kim, MD, Sang-Hag Park, MD, PhD, Hack-Ryul Kim, MD, PhD, Sang-Hoon Kim, MD, PhD and Mun-In Lee, MD

Abstract

Objectives:The purpose of this study was to examine patients leaving the hospital between 2004 and 2006 in a bid to find out the impacts of psychosocial and clinical factors on discharge from the hospital against medical advice (AMA). Subjects and
Methods:The subjects in this study were 347 patients who were discharged from Chosun University Hospital between January 1, 2004 and December 31, 2006 after being hospitalized in the closed ward. Out of them, 71 patients were discharged against medical advice, who were selected as an experimental group. The other 276 patients who were discharged as medical advice (DMA) were grouped into a control group. Their medical and discharge records were reviewed in reverse chronological order to compare the two groups in terms of several demographic and clinical characteristics. The selected demographic characteristics involved age, sex, education, economic status, occupation, religion, status of insurance and place of residence, marital status and the selected clinical characteristics included the route of hospitalization, treatment results, psychiatric symptoms, suicide ideation, grade of the physician in charge past treatment history and family history.
Results:There were difference between the two groups in age, place of residence, marital status, treatment results and suicide ideation. By age, the average age of the experimental group that was discharged AMA was 43.3±15.9, and that of the control group that DMA was 38.2±15.4. The mean age of the former was higher than that of the latter. As to residential area, those who dwelled in the same region as the hospital were more discharged AMA (p=0.016). By marital status, the patients of the discharged AMA had more the married than the control group. and There was a less an unmarried in the former than in the latter (p=0.041). As to treatment results, less changes were found in the experimental group than in the control group, and there was a less favorable turn in the former than in the latter (p<0.01). In regard to suicide ideation, those who had ever attempted suicide before or during the hospitalization were more discharged AMA. The gap between the two was significant (p=0.002).
Conclusion:The findings of the study confirmed that being discharged from the hospital AMA might be affected by the demographic characteristics of patients such as age, place of residence, marital status and their condition during hospitalization such as suicide ideation, and lent credibility to the findings of earlier studies. (Korean J Schizophr Res 2009;12:69-75)

Key Words: Against medical advice,Psychiatric hospital,Clinical characteristics.