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Influence of physicians' attitudes on under-notifying infectious diseases: a longitudinal study
A Figueiras1, E Lado, S Fernández
1Departamento de Medicina Preventiva y Salud Publica, Facultad de Medicina, San Francisco, Santiago de Compostela, A Coruna 15705, Spain. mradolfo@usc.es
Objectives:
To identify practitioners' demographic and professional characteristics associated with reporting of mandatory-reporting diseases (MRDs), and to identify attitudes associated with MRD reporting.
Design:
Longitudinal study.
Setting:
Regional Health Service of Galicia (North-western Spain).
Subjects:
Random sample of 600 physicians.
Main Outcome Measures:
A postal questionnaire was used to measure the physicians' beliefs, knowledge and attitudes regarding MRDs. Associations between the independent variables and outcomes (notification or non-notification of MRDs every week during 1998) were modelled using the Andersen-Gill proportional hazards model.
Results:
The response rate was 60.1%. The following beliefs, knowledge and attitudes were statistically associated with a smaller probability of reporting any given MRD: (1) I would only notify an MRD after confirming diagnosis; (2) the MRD reporting system interferes with my daily clinical practice; (3) besides the legal requirements, I would have to report MRDs as a medical professional; and (4) only the reporting of relevant or severe MRDs is necessary. Under-reporting was not associated with specialization (general or paediatric) or the type of contract (fixed or temporary), but was associated with gender.
Conclusions:
Some physicians' beliefs, knowledge and attitudes regarding MRDs are associated with under-reporting. This suggests that modification of certain attitudes and knowledge in physicians could greatly reduce the under-reporting of MRDs.
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