A survey of oregon emergency physiciansʹ reporting patterns of intoxicated drivers in the state of oregon

Study objectives: Because of low reporting and conviction rates among intoxicated drivers involved in nonfatal motor vehicle crashes, some states have proposed mandatory hospital or provider reporting laws. Oregon recently passed an amendment in May 2003 (ORS 676.260) that mandates that providers notify law enforcement within 5 calendar days of a motor vehicle crash, if a presumed driver had an elevated blood alcohol level. The objectives of our study were to (1) assess physician reporting patterns before and after the introduction of mandatory reporting; (2) assess whether education, type of practice, and knowledge of the law are associated with reporting pattern; and (3) educate and inform Oregon emergency physicians about this new mandatory reporting law. Methods: A 1-page self-assessment survey was mailed to 504 emergency physicians in the state of Oregon in April 2004. The list was compiled by the Oregon Chapter of American College of Emergency Physicians. The survey consisted of 8 questions about demographics, awareness of the law, reporting practice, and opinions on mandatory reporting. Reporting frequency was collected on a 4-point ordinal scale (never, occasionally, most of the time, always) for intoxicated drivers of motor vehicles involved in crashes and intoxicated drivers leaving the emergency department (ED) before and after the law was passed. These values were treated as paired observations and assessed for an increase with the passing of the law (Wilcoxonʹs signed rank test). Associations of postlaw reporting and demographic and knowledge factors were sought (χ2 test). Results: Of the 504 surveys mailed, 250 (50%) were submitted and adequate for analysis. One hundred forty-one (56%) of these 250 physicians were aware of the law. Two hundred twenty-nine (92%) agreed that physicians should be required to report some crimes. Reporting frequency for both motor vehicle crash–involved drivers (MIDs) and drivers leaving the ED (DLEs) increased with the passing of the law. MIDs were always reported by 18% of physicians before the law and by 46% afterward. DLEs were always reported by 56% of physicians before the law and by 66% afterward. Sex and type of residency training were independent of all reporting frequency measures. A greater length of time since residency was associated with increased reporting frequency for MIDs after the law passed. A greater annual ED census was associated with less frequent reporting of DLEs before the law passed. Awareness of the law was associated with increased reporting frequency of MIDs after the law passed. Conclusion: Forty-four percent of responding Oregon emergency physicians are unaware of a mandated reporting law for intoxicated drivers presenting to the ED. However, more physicians are commonly reporting after passage of the law, largely amongst those aware of the law. Years since residency and practice setting influence reporting frequency.