Identifying and Addressing the Hidden Reasons Why Patients Refuse Discharge From the Hospital

Psychosomatics
Jo Ellen WilsonStephen E Nicolson

Abstract

Consultation-liaison psychiatrists are often asked to evaluate patients who refuse discharge from a medical facility. Literature to guide clinicians on the management of these patients is very limited. This article seeks to explain this phenomenon through a case series, provide a differential diagnosis of patients who request to stay in the hospital, as well as provide clinicians with direction in the management of these difficult situations. We discuss a case series of 3 patients treated at a large academic medical center, who refused discharge, discuss potential differential diagnoses, and provide management recommendations to guide clinicians. Providing care for a patient who refuses discharge can present several dilemmas for the treatment provider. Additionally, patients who refuse discharge may face emotional, physical, and financial costs secondary to continued unnecessary medical hospitalization. A variety of psychiatric conditions may contribute to a patient׳s desire to stay in the hospital. Patients who refuse medical discharge can present unique challenges for hospital-based medical providers as well as consultation psychiatrists who care for these patients. Careful consideration of diagnostic etiologies as well as co...Continue Reading

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Citations

Jan 26, 2018·Journal of Bioethical Inquiry·Ryan Essex, David Isaacs
Jun 22, 2021·The American Journal of Bioethics : AJOB·Julie Aultman
Jun 22, 2021·The American Journal of Bioethics : AJOB·David Alfandre

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