Citation

Valevski A, Zalsman G, Tsafrir S, Lipschitz-Elhawi R, Weizman A, Shohat T. Eur. Psychiatry 2012; 27(7): 496-499.

Affiliation

Geha Mental Health Center, 1, Helsinki Street, PO Box 103, 49100 Petach Tikva, Israel; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.eurpsy.2011.04.009

PMID

21705199

Abstract

PURPOSE: To compare the readmission and the mortality rates of schizophrenia patients who were discharged against medical advice (AMA) and patients who were discharged by physician recommendation. METHODS: The records (1984-2005) of all consecutive admissions (n=12,937) of schizophrenia patients (n=8,052) were reviewed. Out of this group, 673 (8.3%) refused to remain in the hospital and signed a hospital form for discharge AMA. Their records were analyzed for rates of re-hospitalization and mortality at study closure. The records of AMA patients were compared to those of patients with regular discharge (n=1345). RESULTS: AMA patients were younger at admission (P<0.001), comprised more males (P<0.01), more were single (P<0.0001), and had a shorter duration of illness than the controls (P<0.05). A total of 49.9% of AMA events occurred within the first 2weeks of hospitalization. The readmission rate was significantly higher for AMA patients than for the controls (P<0.001). The mortality rate as a result of suicide (P<0.0001) and accidents (P<0.05) was higher for AMA patients compared to controls. CONCLUSION: The schizophrenia patients discharged AMA have a higher readmission rate and a higher mortality rate due to suicide and accidents compared to non-AMA discharged patients. Patients with AMA discharge warrant special community surveillance to improve outcome.

Language: en