Maximum Hospital Benefits vs Against Medical Advice

Abstract

IN studying the rising admission and discharge rate at the Veterans Administration Hospital, American Lake, it became apparent that a significant number of patients were leaving the hospital against medical advice. Searching for literature on this subject was not particularly fruitful, although several studies were found.^1-3 Patients who enter the hospital for psychiatric treatment and shortly thereafter leave against medical advice present a considerable problem. This group constituted 14% of discharges at American Lake Veterans Hospital during 1965 and 1966 and has averaged 10% (9.35%) over the past eight years. The actual cost in money and in staff effort to admit a patient is significant. Time factors involved in the admission procedures were analyzed and reported by the California Commission on Staffing Standards for State Mental Hospitals.⁴We took the standard time allowances for the intake procedures from the California