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针对精神科临床医生的执业许可行动:对国家从业者数据库报告的队列分析

Licensure Actions Against Psychiatric Clinicians: A Cohort Analysis of National Practitioner Database Reports.

作者信息

Dadlani Akanksha, Mills Jeffrey A, Strawn Jeffrey R

机构信息

University of Cincinnati Medical Center, Cincinnati, OH.

出版信息

J Psychiatr Pract. 2025 Jan 1;31(1):35-41. doi: 10.1097/PRA.0000000000000831.

Abstract

OBJECTIVE

To examine trends and predictors of administrative actions against psychiatric clinicians' licenses between 2002 and 2022.

METHODS

Data from the National Practitioner Data Bank (NPDB) identified 6400 disciplinary actions against psychiatric clinicians' licenses. Linear trend models assessed the trends of disciplinary actions across mental/physical health, licensing/legal issues, and unprofessional conduct. A first-order autoregressive model with a time indicator interaction term evaluated structural breaks (ie, a sudden or gradual change in the characteristics of data in a time series). Predictors of claims were assessed using logistic regression.

RESULTS

Since 2002, disciplinary actions related to clinicians' mental/physical health (P=0.004) and licensure/legal issues (P=0.018) have decreased, while actions related to unprofessional conduct remained unchanged (P=0.358). Declines emerged in 2012 for mental/physical health (break coefficient -0.367; P=0.026) and in 2009 for unprofessional conduct (break coefficient -0.199; P=0.013). Clinicians facing disciplinary actions related to physical/mental health were significantly younger than those with legal/licensure issues (P<0.001). While the average age remained stable for mental/physical health-related actions, the average age increased for actions related to licensure/legal claims and unprofessional conduct.

CONCLUSIONS

The decrease in disciplinary actions related to physical/mental health may reflect better access and acceptance of treatment of clinicians, while the reduction in licensure/legal actions may indicate policy shifts. Findings regarding age underscore the need for enhanced support for mid and late-career clinicians to promote lifelong learning and practice.

摘要

目的

研究2002年至2022年间针对精神科临床医生执照采取行政行动的趋势及预测因素。

方法

来自国家从业者数据库(NPDB)的数据确定了6400起针对精神科临床医生执照的纪律处分行动。线性趋势模型评估了精神/身体健康、执照/法律问题及不专业行为方面纪律处分行动的趋势。带有时间指标交互项的一阶自回归模型评估了结构断点(即时间序列中数据特征的突然或逐渐变化)。使用逻辑回归评估索赔的预测因素。

结果

自2002年以来,与临床医生精神/身体健康相关的纪律处分行动(P=0.004)和执照/法律问题相关的行动(P=0.018)有所减少,而与不专业行为相关的行动保持不变(P=0.358)。2012年精神/身体健康方面出现下降(断点系数-0.367;P=0.026),2009年不专业行为方面出现下降(断点系数-0.199;P=0.013)。面临与身体/精神健康相关纪律处分行动的临床医生明显比面临法律/执照问题的临床医生年轻(P<0.001)。虽然与精神/身体健康相关行动的平均年龄保持稳定,但与执照/法律索赔及不专业行为相关行动的平均年龄有所增加。

结论

与身体/精神健康相关的纪律处分行动减少可能反映出临床医生获得治疗和接受治疗的情况有所改善,而执照/法律行动的减少可能表明政策发生了转变。关于年龄的研究结果强调需要加强对职业生涯中期和后期临床医生的支持,以促进终身学习和实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eccb/11745757/db8afbe0cc32/pra-31-35-g001.jpg

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