FACTORS ASSOCIATED WITH UNPLANNED DISCHARGE FROM PSYCHIATRIC DAY TREATMENT PROGRAMS - A MULTICENTER STUDY

This study describes and evaluates the adequacy of sociodemographic an d clinical descriptors as potential predictors of unplanned discharge from the completion of psychiatric day treatment programs. A 2-year re trospective chart review was completed on all patients (N = 327) atten ding three university-affiliated day treatment programs. Statistical c omparisons were made between those patients who completed and those wh o had unplanned discharge. Logistic regression was used to generate a predictive model of unplanned discharge using identified variables. Th e rate of unplanned discharge was 54%. Factors associated with program completion were diagnoses of major depression or posttraumatic stress disorder, a history of completing a prior day treatment program, and higher education levels. Active substance abuse and a history of three or more inpatient admissions were associated with unplanned discharge . The predictive model was able to correctly classify 71% of patients completing day treatment programs and 43% of patients with unplanned d ischarges. Traditional demographic and clinical variables contribute d ifferentially to program completion/noncompletion. Given the relativel y poor predictability of unplanned discharge in this study, patient se lection practices based on these factors alone may be somewhat limitin g. Interactive effects of patient and program characteristics need to be addressed to improve program outcome. (C) 1997 Elsevier Science Inc .