거역퇴원 환자의 추적조사

Follow-up Study of Patients Discharged Against Medical Advice

This follow-up survey was conducted on patients discharged from psychiatric wards of Seoul National University Hospital, to compare those who were discharged against medical advice (AMA) with those discharged by the regular process (BMA). The results were as followings: 1. The AM A discharge rate was 11. 5% of total patient samples. 2. Average length of stay for AM A group (23.3days) was shorter than that for BMA group (50.7days). The duration of rehospitalization of AMA group was longer than that of BMA group, but other outcome variables were not different on both group. 3. There were no differences in the major pcstdischarge treatment which were the selfmedication, irregular follow-up visit, and combination of various other treatments. 4. The leading causes of AMA discharge were the disagreement on concepts of mental illness, treatment goal and modality. Our findings did not support several previous publications suggesting that AM A discharges be therapeutic, and short-term hospitalization be better than long-term hospitalization. It is concluded that therapists should try to establish the therapeutic relationship with the family and the patients as possible, and explain about the disease process, treatment goal and modality, importance of social rehabilitation, their involvement in therapeutic process.