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The Effect of Legal and Hospital Policies on Physician Response to Prenatal Substance Exposure

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Abstract

Objectives: To determine the influence of a state's legal environment and a hospital's Prenatal Substance Exposure (PSE) protocol on physicians' propensity to respond when prenatal substance exposure is suspected. Methods: Using a sample of 1367 physicians from every state and the District of Columbia, we formulate a set of linear models to determine the impact of the legal environment and hospital protocol on physicians' response to PSE, the agreement between physicians' perceptions and actual state legal environments, and physicians' motivation to act when PSE is suspected. Results: Both protocol and legal environment showed to be significantly correlated with physicians' propensity to take action when PSE is suspected (p < 0.05). Our analysis shows that physicians prefer a public health (patient-centered) approach to more punitive measures. Conclusions: Our results suggest a policy strategy focused first on enacting laws that would encourage a patient-centered approach, by developing and using hospital protocols to implement state policy, and then on educating physicians about the actual legal environment.

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References

  1. Klein D, Zahad E. Perspectives of pregnant substance-using women: Findings from the California perinatal needs assessment. J Psychoactive Drugs 1997;29:55-67.

    Google Scholar 

  2. Spence M, William R, DiGrgorio G, Kirby-McDonnell A, Polansky M. The relationship between recent cocaine use and pregnancy outcome. Obstet Gynecol 1991;78:326-9.

    Google Scholar 

  3. Birchfield M, Scully J, Hander A. Perinatal screening for illicit drugs: Policies in a hospital in a large metropolitan area. J Perinatol 1995;15:208-14.

    Google Scholar 

  4. MacGregor S, Keith L, Chasnoff I, Rosner M, Chisum G, Shaw P. Cocaine use during pregnancy: Adverse perinatal outcome. Am J Obstet Gynecol 1987;157:686-90.

    Google Scholar 

  5. Whitner v. State of South Carolina, 1997 S.C. Lexis 203 (S.C. 1997).

  6. Zellman G, Jacobson PD, DuPlessis H, DiMatteo MR. Detecting prenatal substance exposure: An exploratory analysis and policy discussion. J Drug Issues 1993;23:375-87.

    Google Scholar 

  7. Chavkin W, Breitbart V, Elman D, Wise PH. National survey of the states: Policies and practices regarding drug-using pregnant women. Am J Public Health 1998;88:117-9.

    Google Scholar 

  8. Zellman GL, Fair CC, Hoube J, Wong M. A search for guidance: Examining prenatal substance exposure protocols. Maternal and Child Health J 2002; 6:205-12.

    Google Scholar 

  9. Zellman GL, Bell R, Archie C, DuPlessis H, Hoube J, Miu A. Physician response to prenatal substance exposure. Maternal and Child Health J 1999;3:29-38.

    Google Scholar 

  10. Berg M. Problems and promises of the protocol. Social Sci Med 1997;44:1081-88.

    Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Health Management and Policy, School of Public Health, The University of Michigan, Ann Arbor, Michigan

    David Mendez, Peter D. Jacobson & Kristen M. Hassmiller

  2. RAND, Santa Monica, California

    Gail L. Zellman

Authors
  1. David Mendez
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  2. Peter D. Jacobson
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  3. Kristen M. Hassmiller
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  4. Gail L. Zellman
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Corresponding author

Correspondence to David Mendez.

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Mendez, D., Jacobson, P.D., Hassmiller, K.M. et al. The Effect of Legal and Hospital Policies on Physician Response to Prenatal Substance Exposure. Matern Child Health J 7, 187–196 (2003). https://doi.org/10.1023/A:1025188405300

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  • DOI: https://doi.org/10.1023/A:1025188405300

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