Characteristics of emergency room patients that predict hospitalization or disposition to alternative treatments.

OBJECTIVE The purpose of the study was to identify variables that predicted three different dispositions of patients seen in a psychiatric emergency room: hospitalization, an emergency housing program, and an outpatient crisis program. METHODS Social, psychiatric, demographic, and vocational characteristics of 50 patients in each disposition group were examined to learn whether they varied sufficiently to explain the different dispositions. RESULTS Patients in the hospitalized group were most psychologically impaired and those in the crisis program group least impaired. Patients referred to emergency housing were more moderately impaired but not always significantly different in impairment from hospitalized patients. Discriminant analysis yielded a model of 11 variables whose combined effect accounted for 79 percent of the variance. Psychiatric determinants were the most important predictors, although social, vocational, and demographic variables were also significant. Using these predictors, 76 percent of the original sample and 63 percent of a cross-validation sample were correctly classified by disposition group. CONCLUSIONS The results confirmed the importance of psychiatric determinants in the dispositional process. The similarity between hospitalized patients and those assigned to emergency housing suggests that some hospitalized patients would be good candidates for alternative treatment.