Braquehais María Dolores, Valero Sergi, Bel Miquel Jordi, Navarro María Cecilia, Matalí Josep Lluís, Nasillo Viviana, Padrós Jaume, Arteman Antoni, Bruguera Eugeni, Casas Miquel
Integral Care Program for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Col·legi Oficial de Metges de Barcelona, Barcelona, Spain Department of Psychiatry and Legal Medicine, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain.
Department of Psychiatry and Legal Medicine, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain.
BMJ Open. 2014 Jul 2;4(7):e005248. doi: 10.1136/bmjopen-2014-005248.
To compare the profile of doctors with mental disorders admitted to a Physicians' Health Program (PHP) depending on their type of referral.
Retrospective chart review.
We analysed 1545 medical records of doctors admitted to the Barcelona PHP (PAIMM) from 1 February 1998 to 31 December 2012.
Most doctors (83.2%) were self-referred to the programme. Patients non-self-referred were older ([Formula: see text]=55 vs [Formula: see text]=49.6 years; t=6.96, p<0.01) than those self-referred and there were more men (68.3%) than women (45.8%; OR=0.39; 95% CI 0.29 to 0.52). Self-referrals were more frequent among patients with non-addictive disorders (84.6% vs 15.4%; OR=4.52; 95% CI 3.23 to 28.45). Self-referred patients needed less inpatient admissions (16.8% vs30.9%; OR=2.22; 95% CI 1.63 to 3.01) and the length of their treatment episodes was shorter ([Formula: see text]=24.3 vs [Formula: see text] = 32.4 months; t=3.34; p<0.01). Logistic regression showed a significant model (χ(2)=67.52; df=3; p<0.001). Age, gender and diagnosis were statistically associated with type of referral to the programme.
Type of referral to a PHP may be influenced not only by sick doctors' personal traits but also by each programme's design and how it is perceived by service users. Our findings should be taken into account when designing treatment and preventive interventions for this professional group.
根据转诊类型比较参加医师健康项目（PHP）的患有精神障碍的医生的概况。
回顾性病历审查。
我们分析了1998年2月1日至2012年12月31日期间入住巴塞罗那PHP（PAIMM）的医生的1545份病历。
大多数医生（83.2%）是自行转诊至该项目的。非自行转诊的患者比自行转诊的患者年龄更大（[公式：见正文]=55岁对[公式：见正文]=49.6岁；t=6.96，p<0.01），男性（68.3%）多于女性（45.8%；OR=0.39；95%CI为0.29至0.52）。非成瘾性障碍患者中自行转诊更为常见（84.6%对15.4%；OR=4.52；95%CI为3.23至28.45）。自行转诊的患者需要的住院次数更少（16.8%对30.9%；OR=2.22；95%CI为1.63至3.01），且其治疗周期的长度更短（[公式：见正文]=24.3对[公式：见正文]=32.4个月；t=3.34；p<0.01）。逻辑回归显示模型具有显著性（χ(2)=67.52；自由度=3；p<0.001）。年龄、性别和诊断与转诊至该项目的类型在统计学上相关。
转诊至PHP的类型可能不仅受患病医生个人特质的影响，还受每个项目的设计以及服务使用者对其的认知的影响。在为这一专业群体设计治疗和预防干预措施时应考虑我们的研究结果。
