The current practices of internists in prevention of residential fire injury

Residential fires are a leading cause of unintentional injury in the United States. We completed a cross-sectional study in an urban internal medicine clinic to describe the patients' risk factors for fire injury and internists' current methods for addressing this health problem. We used a physician self-report survey (n = 301), patient interviews (n = 300), and chart reviews (n = 300) in the evaluation. Among physicians returning the questionnaire (70% response rate), more than 85% demonstrated reasonable knowledge of injury as a major health problem and relatively positive attitudes toward incorporating injury prevention into clinical practice. However, 62% of physicians reported "never" and 23% only "seldom" counseling patients about smoke detectors. Among patients attending the clinic, only 63% reported having a smoke detector in their home. Factors associated with not having a smoke detector through multivariate logistic analysis were black race (odds ratio [OR] = 4.3, confidence interval [CI] = 1.7, 10.6) and patient report that physician did not counsel about smoke detectors (OR = 2.38, Cl = 1.15, 4.90). Age younger than 65 (OR = 1.7, Cl = .93, 2.9) and alcohol abuse (OR 1.5, Cl = .92, 2.5) were borderline in their statistical significance. Eighteen percent of the patients reported being counseled by their physician about smoke detectors, although no documentation appeared in any of the charts. In addition, those patients with risk factors for fire injury did not report being counseled more often than their lower risk counterparts.(ABSTRACT TRUNCATED AT 250 WORDS)