A Model for Predicting Discharge Against Medical Advice From Adolescent Residential Treatment

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.