Redelmeier Donald A, Vinkatesh Vikram, Stanbrook Matthew B
Open Med. 2008;2(1):e8-e17. Epub 2008 Feb 11.
One strategy for the prevention of motor vehicle crashes is physician reporting of medically unfit drivers to vehicle licensing authorities, as mandated by law in Ontario, Canada. We studied drivers involved in life-threatening crashes who required hospital admission to determine how many had previously been seen and reported by a physician in the community.
We identified consecutive drivers involved in a crash who were admitted to Canada's largest trauma centre between 30 June 1996 and 30 June 2001 to assess the prevalence of 3 chronic medical conditions reportable to vehicle licensing authorities (alcohol abuse, cardiac disease, and neurological disorders). We then conducted a case series analysis of linked health and transportation databases to determine how many drivers had previously been seen and reported by a physician in the community.
A total of 1,605 injured drivers were identified, of whom 37% had a reportable condition (95% confidence interval [CI] 35-39). Those with a reportable condition had made a total of 20,505 previous visits to 2,332 physicians during the five years before the crash. The majority of patients with a reportable condition (85%, 95% CI 82-88) had seen a physician in the year before the crash but few (3%, 95% CI 2-4) had been reported to licensing authorities. Alcohol abuse was the most common underlying reportable condition (prevalent in 72% of trauma patients with a reportable condition) and the least common reason for a previous report (reported in 2% of those with a reportable condition).
Unsafe drivers often visit physicians and yet are rarely reported to licensing authorities even under mandatory reporting laws for preventive medical reporting.
预防机动车碰撞的一种策略是医生按照加拿大安大略省法律规定，向车辆许可部门报告医学上不适宜驾驶的司机。我们研究了因危及生命的碰撞事故而需住院治疗的司机，以确定之前有多少人在社区被医生诊治并报告过。
我们确定了1996年6月30日至2001年6月30日期间连续入住加拿大最大创伤中心的碰撞事故司机，以评估可向车辆许可部门报告的三种慢性病（酗酒、心脏病和神经系统疾病）的患病率。然后，我们对关联的健康和交通数据库进行了病例系列分析，以确定之前有多少司机在社区被医生诊治并报告过。
共识别出1605名受伤司机，其中37%患有可报告疾病（95%置信区间[CI] 35 - 39）。患有可报告疾病的司机在碰撞事故前五年共就诊20505次，涉及2332名医生。大多数患有可报告疾病的患者（85%，95% CI 82 - 88）在碰撞事故前一年看过医生，但很少有人（3%，95% CI 2 - 4）被报告给许可部门。酗酒是最常见的潜在可报告疾病（在72%患有可报告疾病的创伤患者中普遍存在），也是之前报告最少的原因（在2%患有可报告疾病的患者中报告过）。
即使在有预防性医疗报告的强制报告法律规定下，不安全驾驶的司机经常看医生，但很少被报告给许可部门。
