Notices of Privacy Practices: a survey of the Health Insurance Portability and Accountability Act of 1996 documents presented to patients at US hospitals.

Abstract:

BACKGROUND:Federal regulation requires hospitals to present patients with a Notice of Privacy Practices (NPP) that contains all stipulated content items, is readable by patients, and posted on institutional web sites. OBJECTIVE:The objective of this study was to determine whether the NPP texts contain the required content, if readability is influenced by local literacy rates, and if readability or the presentation of NPP texts in other languages is influenced by local rates of English proficiency. RESEARCH DESIGN:The authors conducted a cross-sectional study of the web sites of 115 hospitals selected from the US News and World Report list: Best Hospitals in America. MEASURES:English NPP texts were evaluated for 18 content items and readability using the Flesch-Kincaid scale, which assigns the minimal grade level required to read a text (range, 0-16). RESULTS:NPP texts were available for all hospitals (115 of 115). A Spanish-language NPP was available for 25% (29 of 115). All content items were evident in 76% (87 of 115) of hospitals' NPP texts. The average grade-level readability of NPP text was 12.3 (95% confidence interval, 12.0-12.7). Readability was not associated with the rate of local literacy (P = 0.07). Hospitals with a lower local rate of English proficiency had NPP texts that were more difficult to read (P = 0.03) and did not present NPP texts in other languages more frequently (P = 0.15). CONCLUSIONS:Although NPP texts typically cover the stipulated content, they are written beyond the reading capacity of the majority of American adults. Explicit federal guidance is needed to help privacy lawyers draft NPP texts that are both comprehensive and comprehensible. The goals of the Health Insurance Portability and Accountability Act of 1996 Privacy Rule cannot be met with NPP texts patients cannot decipher.

journal_name

Med Care

journal_title

Medical care

authors

Paasche-Orlow MK,Jacob DM,Powell JN

doi

10.1097/01.mlr.0000163646.90393.e4

keywords:

subject

Has Abstract

pub_date

2005-06-01 00:00:00

pages

558-64

issue

6

eissn

0025-7079

issn

1537-1948

pii

00005650-200506000-00006

journal_volume

43

pub_type

杂志文章
  • Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) Physical Functioning Items.

    abstract:BACKGROUND:Physical functioning is an important health domain for adults. OBJECTIVE:Evaluate physical functioning items in Medicare beneficiaries. RESEARCH DESIGN:Survey data from the 2010 Consumer Assessment of Healthcare Providers and Systems Medicare survey. SUBJECTS:The 366,701 respondents were 58% female; 38% w...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000475

    authors: Hays RD,Mallett JS,Gaillot S,Elliott MN

    更新日期:2016-02-01 00:00:00

  • Comparison of generic versus disease-specific measures of functional impairment in patients with cataract.

    abstract::The increased demand for health status measures in evaluating medical interventions has increased the importance of clarifying when to use generic versus disease-specific health status measures. The authors compared the performance of a well known generic health status measure, the Sickness Impact Profile (SIP), and a...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:

    authors: Damiano AM,Steinberg EP,Cassard SD,Bass EB,Diener-West M,Legro MW,Tielsch J,Schein OD,Javitt J,Kolb M

    更新日期:1995-04-01 00:00:00

  • Clinical quality measurement. Comparing chart review and automated methodologies.

    abstract:OBJECTIVES:This study investigates the use of data from automated systems within a large managed care plan to create indicators of clinical quality. METHODS:Measures from the first year of Health Plan Employer Data and Information Set, HEDIS 2.0, are used to compare chart review and automated analysis methodologies. T...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199706000-00001

    authors: Dresser MV,Feingold L,Rosenkranz SL,Coltin KL

    更新日期:1997-06-01 00:00:00

  • Comparing generic and disease-specific measures of physical and role functioning: results from the Veterans Health Study.

    abstract:OBJECTIVES:This study compared the performance of generic measures of Medical Outcome Study Short Form 36-Item Health Survey physical functioning and role limitations with disease-specific measures of physical functioning and role limitations using specific disease attributions for chronic lung disease, chronic low bac...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199802000-00005

    authors: Ren XS,Kazis L,Lee A,Miller DR,Clark JA,Skinner K,Rogers W

    更新日期:1998-02-01 00:00:00

  • Assessing functional status among elderly patients: a comparison of questionnaire and service provider ratings.

    abstract::This paper describes a comparative analysis of questionnaire-based measures of functional status and clinical ratings of disability made by general practitioners and health visitors. Both approaches to functional assessment were used in rating 92 elderly primary care patients in terms of their performance of 13 mobili...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-197908000-00003

    authors: Kaufert JM,Green S,Dunt DR,Corkhill R,Creese AL,Locker D

    更新日期:1979-08-01 00:00:00

  • Children's health care and the changing role of women.

    abstract::The pivotal role of women as wife, mother or adult daughter in performing health-related activities for family members has received little attention from health researchers or policymakers. Yet the majority of health problems do not reach the medical care system, but are dealt with informally or through other social s...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198012000-00006

    authors: Carpenter ES

    更新日期:1980-12-01 00:00:00

  • Health perceptions of primary care patients and the influence on health care utilization.

    abstract::This prospective study was conducted to determine the influence of primary care patients' health perceptions on their utilization of health care services. Patients' health perceptions were measured using the RAND Corporation's General Health Perceptions Questionnaire. Physicians provided scores of how they thought the...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198903001-00009

    authors: Connelly JE,Philbrick JT,Smith GR Jr,Kaiser DL,Wymer A

    更新日期:1989-03-01 00:00:00

  • Review of methods to determine VA health care costs.

    abstract:BACKGROUND:Estimates of health care cost are needed to conduct cost-effectiveness research at the facilities operated by the US Department of Veterans Affairs. METHODS:The medical literature was searched for VA studies to characterize different cost methods and identify their advantages and disadvantages. RESULTS:Dif...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/00005650-199904002-00003

    authors: Barnett PG

    更新日期:1999-04-01 00:00:00

  • Negligent care and malpractice claiming behavior in Utah and Colorado.

    abstract:BACKGROUND:Previous studies relating the incidence of negligent medical care to malpractice lawsuits in the United States may not be generalizable. These studies are based on data from 2 of the most populous states (California and New York), collected more than a decade ago, during volatile periods in the history of ma...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200003000-00002

    authors: Studdert DM,Thomas EJ,Burstin HR,Zbar BI,Orav EJ,Brennan TA

    更新日期:2000-03-01 00:00:00

  • Coronary artery bypass surgery: the relationship between inhospital mortality rate and surgical volume after controlling for clinical risk factors.

    abstract::This study uses a new database containing clinical risk factors for cardiac surgery to investigate the relationship between surgical volume (hospital and surgeon) and inhospital mortality rate for all patients receiving coronary artery bypass surgery in New York State in 1989. Also, hospitals with significantly higher...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:

    authors: Hannan EL,Kilburn H Jr,Bernard H,O'Donnell JF,Lukacik G,Shields EP

    更新日期:1991-11-01 00:00:00

  • Self-rated health assessed by web versus mail modes in a mixed mode survey: the digital divide effect and the genuine survey mode effect.

    abstract:OBJECTIVE:To investigate differences in self-rated health (SRH) between web and mail questionnaires in a mixed mode survey and to provide a model that explains those differences. SUBJECTS:A total of 15,200 mail respondents and 17,829 web respondents from the 2008 US National Health Survey conducted by the Gallup Panel...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e31829a4f92

    authors: Shim JM,Shin E,Johnson TP

    更新日期:2013-09-01 00:00:00

  • Should Do-Not-Resuscitate status be included as a mortality risk adjustor? The impact of DNR variations on performance reporting.

    abstract:BACKGROUND:The practice of ordering "Do-Not-Resuscitate" (DNR) varies across hospitals. No research has explored how the DNR variation would affect cross-institutional performance reporting when DNR status is used as a risk adjustor. OBJECTIVE:We sought to assess the impact of DNR variation on performance reporting. ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000167106.09265.4e

    authors: Tabak YP,Johannes RS,Silber JH,Kurtz SG

    更新日期:2005-07-01 00:00:00

  • Measuring the job satisfaction of physicians in organized settings.

    abstract::The accurate measurement of physician job satisfaction in organized practice settings is important for both policy and administrative purposes. Previous efforts to measure physician job satisfaction have been unsatisfactory because of either conceptual or methodologic weaknesses. New measures of physician job satisfac...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198401000-00005

    authors: Lichtenstein R

    更新日期:1984-01-01 00:00:00

  • Effects of State-level Medicaid Expansion on Veterans Health Administration Dual Enrollment and Utilization: Potential Implications for Future Coverage Expansions.

    abstract:OBJECTIVE:The objective of this study was to examine how pre-Affordable Care Act (ACA) state-level Medicaid expansions affect dual enrollment and utilization of Veterans Health Administration (VA) and Medicaid-funded care. RESEARCH DESIGN:We employed difference-in-difference analysis to determine the association betwe...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001327

    authors: O'Mahen PN,Petersen LA

    更新日期:2020-06-01 00:00:00

  • Maximizing compliance with hemoccult screening for colon cancer in clinical practice.

    abstract::A factorial design randomized controlled trial to test several clinically feasible strategies primary-care practitioners may use in routine practice to increase patient participation in occult blood testing for colorectal cancer is reported. Three compliance-enhancing intervention strategies (physician/nurse talk, and...

    journal_title:Medical care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00005650-198610000-00004

    authors: Thompson RS,Michnich ME,Gray J,Friedlander L,Gilson B

    更新日期:1986-10-01 00:00:00

  • The accuracy of administrative data for identifying the presence and timing of admission to intensive care units in a Canadian province.

    abstract:BACKGROUND:A prerequisite for using administrative data to study the care of critically ill patients in intensive care units (ICUs) is that it accurately identifies such care. Only limited data exist on this subject. OBJECTIVE:To assess the accuracy of administrative data in the Canadian province of Manitoba for ident...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318245a754

    authors: Garland A,Yogendran M,Olafson K,Scales DC,McGowan KL,Fransoo R

    更新日期:2012-03-01 00:00:00

  • A comparison of contract-managed and traditionally managed nonprofit hospitals.

    abstract::During the past five years, contract management of nonprofit hospitals by for-profit corporations has increased markedly. However, while a number of studies have been conducted on investor-owned hospitals and proprietary hospital systems, contract-managed hospitals have not been evaluated systematically. This paper re...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198006000-00002

    authors: Biggs EL,Kralewski JE,Brown GD

    更新日期:1980-06-01 00:00:00

  • Benchmarking Veterans Affairs Medical Centers in the delivery of preventive health services: comparison of methods.

    abstract:OBJECTIVE:To identify consistent provision of clinical preventive services, we sought to benchmark all acute care Veterans Affairs Medical Centers (VAMCs) against each other nationally on the basis of multiple evidence-based, performance measures to identify facilities performing consistently higher and lower than expe...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200206000-00011

    authors: Doebbeling BN,Vaughn TE,Woolson RF,Peloso PM,Ward MM,Letuchy E,BootsMiller BJ,Tripp-Reimer T,Branch LG

    更新日期:2002-06-01 00:00:00

  • Barriers to health care among people with disabilities who are members of underserved racial/ethnic groups: a scoping review of the literature.

    abstract:BACKGROUND:Understanding barriers to health care access experienced by people with disabilities who are members of underserved racial/ethnic groups is key to developing interventions to improve access. OBJECTIVE:To conduct a scoping review of the literature to examine the published literature on barriers to health car...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/MLR.0000000000000195

    authors: Peterson-Besse JJ,Walsh ES,Horner-Johnson W,Goode TD,Wheeler B

    更新日期:2014-10-01 00:00:00

  • Rural-Urban Differences in Medicare Quality Outcomes and the Impact of Risk Adjustment.

    abstract:BACKGROUND:There has been considerable debate in recent years about whether, and how, to risk-adjust quality measures for sociodemographic characteristics. However, geographic location, especially rurality, has been largely absent from the discussion. OBJECTIVE:To examine differences by rurality in quality outcomes, a...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000761

    authors: Henning-Smith C,Kozhimannil K,Casey M,Prasad S,Moscovice I

    更新日期:2017-09-01 00:00:00

  • The disparity in access to new medication by type of health insurance: lessons from Germany.

    abstract:BACKGROUND:Drug provision within the German statutory health insurance system has undergone several reforms, including the introduction of drug macrobudgets in 1993. OBJECTIVE:The objective of this study was to investigate the extent to which statutorily (SHI) and fully privately (PHI) health-insured patients were pro...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000124265.13559.02

    authors: Krobot KJ,Miller WC,Kaufman JS,Christensen DB,Preisser JS,Ibrahim MA

    更新日期:2004-05-01 00:00:00

  • A comparison of the patients and practices of recent graduates of family practice and general internal medicine residency programs.

    abstract::This study compares the characteristics of the practices and patients of recent graduates of family practice and general internal medicine residency programs. National samples of 104 family physicians and 134 general internists completed questionnaires and provided log-diary data for more than 7,500 office visits and ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198612000-00006

    authors: Cherkin DC,Rosenblatt RA,Hart LG,Schleiter MK

    更新日期:1986-12-01 00:00:00

  • Predictors of aggressive therapy for nonmetastatic prostate carcinoma in Massachusetts from 1998 to 2002.

    abstract:BACKGROUND:Most studies have found that black men are less likely to receive aggressive therapy for nonmetastatic prostate cancer, even after controlling for covariates. However, previous studies have not accounted for the clustering of outcomes by facility. OBJECTIVE:We sought to compare the proportions of black and ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000257144.29928.f0

    authors: Rose AJ,Backus BM,Gershman ST,Santos P,Ash AS,Battaglia TA

    更新日期:2007-05-01 00:00:00

  • An Economic Analysis of the Implementation of Team-based Collaborative Care in Outpatient General Mental Health Clinics.

    abstract:BACKGROUND:Collaborative Chronic Care Models represent an evidence-based way to structure care for chronic conditions, including mental health conditions. Few studies, however, have examined the cost implications of collaborative care for mental health. OBJECTIVE:We aimed to conduct an economic analysis of implementin...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001372

    authors: Miller CJ,Griffith KN,Stolzmann K,Kim B,Connolly SL,Bauer MS

    更新日期:2020-10-01 00:00:00

  • Effects of Cardiovascular Health Shocks on Spouses' Work and Earnings: A National Study.

    abstract:BACKGROUND:Acute health shocks can reduce the ability to work and earn among working-age survivors. The full economic impact includes labor market effects on spouses/partners, but there is a knowledge gap in this area. OBJECTIVES:The objective of this study was to assess how 3 common health shocks, acute myocardial in...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001249

    authors: Jeon SH,Stepner M,Rotermann M,Fransoo R,Sanmartin C,Scales DC,Wunsch H,Iwashyna TJ,Garland A

    更新日期:2020-02-01 00:00:00

  • Case managed residential care for homeless addicted veterans. Results of a true experiment.

    abstract:OBJECTIVES:The effectiveness of case-managed residential care (CMRC) in reducing substance abuse, increasing employment, decreasing homelessness, and improving health was examined. METHODS:A five-year prospective experiment included 358 homeless addicted male veterans 3, 6, and 9 months during their enrollment and at ...

    journal_title:Medical care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00005650-199801000-00006

    authors: Conrad KJ,Hultman CI,Pope AR,Lyons JS,Baxter WC,Daghestani AN,Lisiecki JP Jr,Elbaum PL,McCarthy M Jr,Manheim LM

    更新日期:1998-01-01 00:00:00

  • Chiropractic and medical costs of low back care.

    abstract::This study compares health insurance payments and patient utilization patterns for episodes of care for common lumbar and low back conditions treated by chiropractic and medical providers. Using 2 years of insurance claims data, this study examines 6,183 patients who had episodes with medical or chiropractic first-con...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199603000-00001

    authors: Stano M,Smith M

    更新日期:1996-03-01 00:00:00

  • Association of physician specialty and medical therapy for benign prostatic hyperplasia.

    abstract:BACKGROUND:Despite little available evidence to determine whether recently introduced selective α-1 blockers and 5-α reductase inhibitors (5-ARIs) are superior to the existing agents in treating benign prostatic hyperplasia (BPH), they are being increasingly prescribed. OBJECTIVE:To describe the prescribing patterns o...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000078

    authors: Han LC,Kim SP,Gross CP,Ross JS,Van Houten HK,Smaldone MC,Krambeck AE,Shah ND

    更新日期:2014-02-01 00:00:00

  • Social support and risk-adjusted mortality in a frail older population.

    abstract:OBJECTIVE:The objective of this study was to test the hypothesis that social support is an important predictor of mortality in a frail older population receiving formal long-term care services. RESEARCH DESIGN AND METHODS:The analysis is based on 3138 individuals enrolled in 28 Programs of All-Inclusive Care for the E...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000132397.49094.b3

    authors: Temkin-Greener H,Bajorska A,Peterson DR,Kunitz SJ,Gross D,Williams TF,Mukamel DB

    更新日期:2004-08-01 00:00:00

  • Extended use of indwelling urinary catheters in postoperative hip fracture patients.

    abstract:BACKGROUND:Indwelling urinary catheters are used postoperatively in hip fracture care. Their use beyond the immediate postoperative period may result in excess nosocomial infections. OBJECTIVES:The objectives of this study were to explore the relationship between extended indwelling urinary catheterization and outcome...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000178199.07789.32

    authors: Wald H,Epstein A,Kramer A

    更新日期:2005-10-01 00:00:00