From the American Board of Anesthesiology, Raleigh, North Carolina (Y.Z., H.S., A.M., M.T.K., A.J.P., T.W., A.E.H., D.O.W.) Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California (A.M.) Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota (M.T.K., D.O.W.) Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska (A.J.P.) Department of Anesthesia and Critical Care, The University of Chicago, Chicago, Illinois (M.M.M.).
Anesthesiology. 2018 Oct;129(4):812-820. doi: 10.1097/ALN.0000000000002326.
WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: In 2000, the American Board of Anesthesiology (Raleigh, North Carolina) began issuing time-limited certificates requiring renewal every 10 yr through a maintenance of certification program. This study investigated the association between performance in this program and disciplinary actions against medical licenses.
The incidence of postcertification prejudicial license actions was compared (1) between anesthesiologists certified between 1994 and 1999 (non-time-limited certificates not requiring maintenance of certification) and those certified between 2000 and 2005 (time-limited certificates requiring maintenance of certification); (2) within the non-time-limited cohort, between those who did and did not voluntarily participate in maintenance of certification; and (3) within the time-limited cohort, between those who did and did not complete maintenance of certification requirements within 10 yr.
The cumulative incidence of license actions was 3.8% (587 of 15,486). The incidence did not significantly differ after time-limited certificates were introduced (hazard ratio = 1.15; 95% CI, 0.95 to 1.39; for non-time-limited cohort compared with time-limited cohort). In the non-time-limited cohort, 10% (n = 953) voluntarily participated in maintenance of certification. Maintenance of certification participation was associated with a lower incidence of license actions (hazard ratio = 0.60; 95% CI, 0.38 to 0.94). In the time-limited cohort, 90% (n = 5,329) completed maintenance of certification requirements within 10 yr of certificate issuance. Not completing maintenance of certification requirements (n = 588) was associated with a higher incidence of license actions (hazard ratio = 4.61; 95% CI, 3.27 to 6.51).
These findings suggest that meeting maintenance of certification requirements is associated with a lower likelihood of being disciplined by a state licensing agency. The introduction of time-limited certificates in 2000 was not associated with a significant change in the rate of license actions.
本文告诉我们新的内容：背景：2000 年，美国麻醉委员会（北卡罗来纳州罗利）开始颁发有限期证书，要求通过认证维护计划每 10 年更新一次。这项研究调查了该计划的表现与医疗执照纪律处分之间的关联。
比较（1）1994 年至 1999 年（无期限证书，无需维护认证）和 2000 年至 2005 年（有限期证书，需要维护认证）之间认证的麻醉师之间的认证后有害执照行为的发生率；（2）在无期限队列中，自愿参加或不参加维护认证之间的差异；（3）在有限期队列中，在 10 年内完成或未完成维护认证要求之间的差异。
许可证行为的累积发生率为 3.8%（15486 名中的 587 名）。引入有限期证书后，发生率没有显著差异（危险比=1.15；95%CI，0.95 至 1.39；与无期限队列相比）。在无期限队列中，有 10%（n=953）自愿参加维护认证。参加维护认证与较低的执照行为发生率相关（危险比=0.60；95%CI，0.38 至 0.94）。在有限期队列中，有 90%（n=5329）在证书颁发后 10 年内完成了维护认证要求。未完成维护认证要求（n=588）与更高的执照行为发生率相关（危险比=4.61；95%CI，3.27 至 6.51）。
这些发现表明，满足维护认证要求与更不可能受到州许可机构纪律处分相关。2000 年引入有限期证书与执照行为发生率的显著变化无关。
