Nelson H D, Matthews A M, Girard D E, Bloom J D
Department of Medicine, Oregon Health Sciences University, Portland, USA.
West J Med. 1996 Jul-Aug;165(1-2):31-6.
We compared the characteristics and treatment outcomes of substance-impaired physicians monitored by two different programs in Oregon: a probationary program administered by the Oregon Board of Medical Examiners and the confidential, voluntary Diversion Program for Health Professionals. Demographic, substance use, and treatment outcome variables were obtained by a retrospective medical record review from 41 physicians monitored by the Oregon board and 56 physicians monitored by the diversion program during a 3-year study period. Compared with physicians monitored by the Oregon board, physicians in the diversion program were younger, more likely to be in training programs and less likely to be in hospital-based practice settings, more often reported by immediate rather than third-party contacts, more likely to choose in-state inpatient treatment than out-of-state treatment, and less likely to have concurrent mental illness diagnoses (P < .05 for all comparisons). Short-term relapse rates did not differ statistically between the groups (22.0% for the Oregon board group, 14.3% for the diversion program group). The higher number of younger physicians and physicians in training and tendency toward increased reporting by immediate contacts in the diversion program suggested earlier intervention than in the Oregon board group.
一个是由俄勒冈州医学考试委员会管理的试用期项目，另一个是针对医疗专业人员的保密自愿性转移项目。通过回顾性病历审查，获取了在3年研究期间由俄勒冈州委员会监管的41名医生和由转移项目监管的56名医生的人口统计学、药物使用和治疗结果变量。与由俄勒冈州委员会监管的医生相比，转移项目中的医生更年轻，更有可能参加培训项目，在医院执业环境中的可能性更小，更多是由直接接触者而非第三方接触者报告，更倾向于选择州内住院治疗而非州外治疗，并发精神疾病诊断的可能性更小（所有比较的P值均<0.05）。两组的短期复发率在统计学上没有差异（俄勒冈州委员会组为22.0%，转移项目组为14.3%）。转移项目中年轻医生和参加培训的医生数量较多，以及直接接触者报告增加的趋势表明，该项目比俄勒冈州委员会组的干预更早。
