An intervention to reduce the rate of hospital discharges against medical advice.

The initiation of a patient advocacy program in a private psychiatric hospital in 1980 was effective in significantly reducing the rate of hospital discharges against medical advice relative to the rate in 1979 and in 1978. There was also a concomitant increase in the rate of clinically approved discharges relative to that in 1979 and in 1978. The authors view the patient advocate as an objective intermediary who represents an acknowledgment of patients' rights and affords patients an opportunity to have some autonomy and an impact on the hospital system.