Senior N, Kibbee P
Psychiatr Hosp. 1986 Winter;17(1):33-6.
Previous attempts to determine a profile of the typical patient who leaves against medical advice (AMA) have been largely unsuccessful. The premature separation from the hospital arouses unresolved feelings in everyone involved, including the patient, and is expensive as well. The theory that a patient left AMA as a result of a malfunction in the contracting process on admission was not replicable in our institution. We found that the largest group of patients leaving AMA was the young male substance abuser, who is usually the most unpopular type of patient. We believe that staff, actively or passively, encourage patients that they do not like to leave AMA. This interpersonal process may be the one which most needs addressing.
此前确定擅自离院（AMA）典型患者特征的尝试大多未成功。过早离开医院会引发包括患者在内的所有相关人员心中难以释怀的情绪，而且成本高昂。患者因入院时签约流程出现故障而擅自离院的理论在我们机构无法得到验证。我们发现，擅自离院的患者中最大的群体是年轻男性药物滥用者，这类患者通常是最不受欢迎的。我们认为，工作人员有意或无意地鼓励他们不喜欢的患者擅自离院。这种人际过程可能是最需要解决的问题。
