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.