2021 AM Posters-Factors for Leaving Against Medical Advice from Inpatient

Factors for Leaving Against Medical Advice from Inpatient

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This study examined the sociodemographic and clinic profiles of psychiatric patients who left against medical advice (AMA) during the COVID-19 pandemic. The study included 374 participants who were either discharged or left AMA from a detoxification facility. The data collected from patient questionnaires looked at variables such as demographics, psychiatric and substance use history, social obligations, attitude, and satisfaction.<br /><br />The findings showed that 45.2% of the surveyed patients left the detoxification unit AMA. Younger age was associated with a higher incidence of leaving AMA. Patients who identified as "other" in terms of race/ethnicity had a higher percentage of leaving AMA compared to those who identified as White, African American, or Hispanic. The study did not find a correlation among AMA rates for African American, White, and Hispanic patients.<br /><br />The multivariate analysis revealed that current substance use detoxing for alcohol, fear of contracting COVID-19, and identifying as "other" in terms of race/ethnicity were significantly associated with a higher likelihood of leaving AMA.<br /><br />The study also found that patients who felt their withdrawal symptoms were managed well by healthcare providers and were satisfied with the program, facility comfortableness, and the treatment team's support were less likely to leave AMA.<br /><br />The study suggests that the type of substance use, ethnicity, and fear of COVID-19 should be monitored to categorize high-risk patients and make appropriate accommodations. Patients who use alcohol and heroin may require additional resources and attention to prevent treatment non-completion. The findings can also be applied to adjust medical practices during future crises similar to the COVID-19 pandemic, in order to compensate for their effects on AMA rates.

Keywords

psychiatric patients

medical advice

COVID-19 pandemic

detoxification facility

questionnaires

substance use history

withdrawal symptoms

healthcare providers

treatment team

high-risk patients

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