Patient characteristics in unplanned discharge from day hospital.

In order to identify the distinguishing characteristics of patients with unplanned discharges from day hospital, the author reviewed 96% of all 1987 admissions. Unplanned discharges included precipitous in-patient hospitalization, discharge before 30-day program completion, and discharge against medical advice. Forty-three percent of reviewed admissions ended by unplanned discharge. Psychiatric patients with recent and/or remote substance abuse, and patients with multiple day-hospital admissions were especially vulnerable to unplanned discharge. Use of a backup bed during admission and being referred from the general-hospital emergency room or parent mental-health facility were associated with high rates of unplanned discharge. Patients with multiple admissions were more likely than those with a single admission to have personality disorders and to be female and white. Using logistic regression analysis, the author found that when patients had several characteristics increasing their risk for unplanned discharge, the odds of leaving before program completion were considerable.