title: [Are our medical centres for fitness to drive and firearms licences effective?].
abstract: OBJECTIVE
  This article aimed to evaluate the effectiveness of medical centres in the assessment of medical fitness for driving and gun licences, as well as describing the differences between them.
  
  
  METHODS
  Using a crossover design and a representative sample of holders of driving and firearms licences in the province of Malaga during 2014 (363 reports for driving licenses and 626 for firearms licenses), an assessment was made of fitness report issued by the centres by comparing it with the records of the Andalusian public health service. The proportion of those that would not meet the legal eligibility requirements was calculated. An analysis was made of the origin of the disagreements as regards the information made available by the centres.
  
  
  RESULTS
  The discordance in the assessment of fitness to drive was estimated as 15.4% (95% CI: 12.0 to 19.4), while for firearms licenses it was 2.7 times higher (41.4%). The origin of the discordance is related to the information provided to the centres, rather than the assessment made by them.
  
  
  CONCLUSIONS
  The limited effectiveness of the centres in the assessment of fitness for driving and, especially, for firearms licenses, could be improved by increased monitoring of their activity, providing health workers with adequate training and access to healthcare records of applicants.
authors.affiliation: Equipo Provincial de Inspección de Málaga, Delegación Territorial de Málaga de la Consejería de Igualdad, Salud y Políticas sociales (Junta de Andalucía), Málaga, España. Electronic address: pgfortea@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: García-Fortea
authors.affiliation: Equipo Provincial de Inspección de Málaga, Delegación Territorial de Málaga de la Consejería de Igualdad, Salud y Políticas sociales (Junta de Andalucía), Málaga, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Estebaranz-García
authors.affiliation: Equipo Provincial de Inspección de Málaga, Delegación Territorial de Málaga de la Consejería de Igualdad, Salud y Políticas sociales (Junta de Andalucía), Málaga, España.
authors.forename: M D
authors.initials: MD
authors.lastname: Heredia-Civantos
authors.affiliation: Equipo Provincial de Inspección de Málaga, Delegación Territorial de Málaga de la Consejería de Igualdad, Salud y Políticas sociales (Junta de Andalucía), Málaga, España.
authors.forename: A
authors.initials: A
authors.lastname: Bermúdez-Virgós
authors.affiliation: Equipo Provincial de Inspección de Málaga, Delegación Territorial de Málaga de la Consejería de Igualdad, Salud y Políticas sociales (Junta de Andalucía), Málaga, España.
authors.forename: J
authors.initials: J
authors.lastname: Rodríguez-Ortega
mesh_terms: D001334:Automobile Driving; D004608:Eligibility Determination; D005389:Firearms; D006801:Humans; D008004:Licensure
keywords: Aptitud; Aptitude; Armas de fuego; Auditoría médica; Automobile driving; Conducción de automóviles; España; Firearms; Licence; Licencia; Medical audit; Spain