THE U.S. HEALTH DATA PRIVACY DEBATE

1999 ◽  
Vol 15 (2) ◽  
pp. 316-331 ◽  
Author(s):  
Phyllis Freeman ◽  
Anthony Robbins

After 25 years of debate about privacy of automated personal health data, the U.S. Congress has set a deadline of August 1999 for enacting health information privacy legislation. The urgency to establish national policy in the United States re-emerges with implementation of a 1996 law mandating a unique identifier for each participant in the U.S. medical care system and the use of a uniform electronic data set for all health information transmitted in financial and administrative transactions. The impact of electronic data storage and transmittal on privacy, health outcomes, and medical care is unclear. A three-step analytic scheme can clarify the issues in the policy debate and for future assessment. The first step is intended to elicit, for the first time, a precise, accurate, and reproducible description of personal health data transactions and chains of transactions, independent of the policy preferences of any interested party. The second step allows the reader to analyze these transactions according to who benefits first and foremost from each. This scrutiny clarifies the reasons why parties to the debate tend to disagree. The third step characterizes how Congress is likely to perceive the policy process and consider its options before enacting any particular set of compromises. Understanding the policy deliberations and potential effects of evolving information technologies and new national privacy rules should aid assessment of results.

2013 ◽  
Vol 99 (4) ◽  
pp. 40-45 ◽  
Author(s):  
Aaron Young ◽  
Philip Davignon ◽  
Margaret B. Hansen ◽  
Mark A. Eggen

ABSTRACT Recent media coverage has focused on the supply of physicians in the United States, especially with the impact of a growing physician shortage and the Affordable Care Act. State medical boards and other entities maintain data on physician licensure and discipline, as well as some biographical data describing their physician populations. However, there are gaps of workforce information in these sources. The Federation of State Medical Boards' (FSMB) Census of Licensed Physicians and the AMA Masterfile, for example, offer valuable information, but they provide a limited picture of the physician workforce. Furthermore, they are unable to shed light on some of the nuances in physician availability, such as how much time physicians spend providing direct patient care. In response to these gaps, policymakers and regulators have in recent years discussed the creation of a physician minimum data set (MDS), which would be gathered periodically and would provide key physician workforce information. While proponents of an MDS believe it would provide benefits to a variety of stakeholders, an effort has not been attempted to determine whether state medical boards think it is important to collect physician workforce data and if they currently collect workforce information from licensed physicians. To learn more, the FSMB sent surveys to the executive directors at state medical boards to determine their perceptions of collecting workforce data and current practices regarding their collection of such data. The purpose of this article is to convey results from this effort. Survey findings indicate that the vast majority of boards view physician workforce information as valuable in the determination of health care needs within their state, and that various boards are already collecting some data elements. Analysis of the data confirms the potential benefits of a physician minimum data set (MDS) and why state medical boards are in a unique position to collect MDS information from physicians.


1997 ◽  
Vol 24 (1) ◽  
pp. 117-141 ◽  
Author(s):  
T. A. LEE

This study represents part of a long-term research program to investigate the influence of U.K. accountants on the development of professional accountancy in other parts of the world. It examines the impact of a small group of Scottish chartered accountants who emigrated to the U.S. in the late 1800s and early 1900s. Set against a general theory of emigration, the study's main results reveal the significant involvement of this group in the founding and development of U.S. accountancy. The influence is predominantly with respect to public accountancy and its main institutional organizations. Several of the individuals achieved considerable eminence in U.S. public accountancy.


2002 ◽  
Vol 28 (4) ◽  
pp. 491-502
Author(s):  
Mary L. Durham

While the new Health Insurance Privacy and Accountability Act (HIPAA) research rules governing privacy, confidentiality and personal health information will challenge the research and medical communities, history teaches us that the difficulty of this challenge pales in comparison to the potential harms that such regulations are designed to avoid. Although revised following broad commentary from researchers and healthcare providers around the country, the HIPAA privacy requirements will dramatically change the way healthcare researchers do their jobs in the United States. Given our reluctance to change, we risk overlooking potentially valid reasons why access to personal health information is restricted and regulated. In an environment of electronic information, public concern, genetic information and decline of public trust, regulations are ever-changing. Six categories of HIPAA requirements stand out as transformative: disclosure accounting/tracking, business associations, institutional review board (IRB) changes, minimum necessary requirements, data de-identification, and criminal and civil penalties.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S489-S490
Author(s):  
John T Henderson ◽  
Evelyn Villacorta Cari ◽  
Nicole Leedy ◽  
Alice Thornton ◽  
Donna R Burgess ◽  
...  

Abstract Background There has been a dramatic rise in IV drug use (IVDU) and its associated mortality and morbidity, however, the scope of this effect has not been described. Kentucky is at the epicenter of this epidemic and is an ideal place to better understand the health complications of IVDU in order to improve outcomes. Methods All adult in-patient admissions to University of Kentucky hospitals in 2018 with an Infectious Diseases (ID) consult and an ICD 9/10 code associated with IVDU underwent thorough retrospective chart review. Demographic, descriptive, and outcome data were collected and analyzed by standard statistical analysis. Results 390 patients (467 visits) met study criteria. The top illicit substances used were methamphetamine (37.2%), heroin (38.2%), and cocaine (10.3%). While only 4.1% of tested patients were HIV+, 74.2% were HCV antibody positive. Endocarditis (41.1%), vertebral osteomyelitis (20.8%), bacteremia without endocarditis (14.1%), abscess (12.4%), and septic arthritis (10.4%) were the most common infectious complications. The in-patient death rate was 3.0%, and 32.2% of patients were readmitted within the study period. The average length of stay was 26 days. In multivariable analysis, infectious endocarditis was associated with a statistically significant increase in risk of death, ICU admission, and hospital readmission. Although not statistically significant, trends toward mortality and ICU admission were identified for patients with prior endocarditis and methadone was correlated with decreased risk of readmission and ICU stay. FIGURE 1: Reported Substances Used FIGURE 2: Comorbidities FIGURE 3: Types of Severe Infectious Complications Conclusion We report on a novel, comprehensive perspective on the serious infectious complications of IVDU in an attempt to measure its cumulative impact in an unbiased way. This preliminary analysis of a much larger dataset (2008-2019) reveals some sobering statistics about the impact of IVDU in the United States. While it confirms the well accepted mortality and morbidity associated with infective endocarditis and bacteremia, there is a significant unrecognized impact of other infectious etiologies. Additional analysis of this data set will be aimed at identifying key predictive factors in poor outcomes in hopes of mitigating them. Disclosures All Authors: No reported disclosures


Author(s):  
David P. Lindstrom

This analysis draws on binational data from an ethnosurvey conducted in Guatemala and in the United States in Providence, Rhode Island, to develop a refinement of the weighting scheme that the Mexican Migration Project (MMP) uses. The alternative weighting procedure distinguishes between temporary and settled migrants by using a question on household location in the Guatemala questionnaire that is not used in the MMP. Demographic characteristics and integration experiences of the most recent U.S. trip are used to assess the composition and representativeness of the U.S. sample. Using a composite index of migrant integration to compare the impact of alternative U.S. sample weights on point estimates, I find that although the U.S. sample is broadly representative across a range of background characteristics, the MMP sample weighting procedure biases estimates of migrant integration downward.


2014 ◽  
Vol 41 (1) ◽  
pp. 60-75
Author(s):  
Tomasz M. Napiórkowski

Abstract The aim of this research is to asses the hypothesis that foreign direct investment (FDI) and international trade have had a positive impact on innovation in one of the most significant economies in the world, the United States (U.S.). To do so, the author used annual data from 1995 to 2010 to build a set of econometric models. In each model, 11 in total) the number of patent applications by U.S. residents is regressed on inward FDI stock, exports and imports of the economy as a collective, and in each of the 10 SITC groups separately. Although the topic of FDI is widely covered in the literature, there are still disagreements when it comes to the impact of foreign direct investment on the host economy [McGrattan, 2011]. To partially address this gap, this research approaches the host economy not only as an aggregate, but also as a sum of its components (i.e., SITC groups), which to the knowledge of this author has not yet been done on the innovation-FDI-trade plane, especially for the U.S. Unfortunately, the study suffers from the lack of available data. For example, the number of patents and other used variables is reported in the aggregate and not for each SITC groups (e.g., trade). As a result, our conclusions regarding exports and imports in a specific SITC category (and the total) impact innovation in the U.S. is reported in the aggregate. General notions found in the literature are first shown and discussed. Second, the dynamics of innovation, trade and inward FDI stock in the U.S. are presented. Third, the main portion of the work, i.e. the econometric study, takes place, leading to several policy applications and conclusions.


2021 ◽  
pp. 003232922110507
Author(s):  
Gillian Slee ◽  
Matthew Desmond

In recent years, housing costs have outpaced incomes in the United States, resulting in millions of eviction filings each year. Yet no study has examined the link between eviction and voting. Drawing on a novel data set that combines tens of millions of eviction and voting records, this article finds that residential eviction rates negatively impacted voter turnout during the 2016 presidential election. Results from a generalized additive model show eviction’s effect on voter turnout to be strongest in neighborhoods with relatively low rates of displacement. To address endogeneity bias and estimate the causal effect of eviction on voting, the analysis treats commercial evictions as an instrument for residential evictions, finding that increases in neighborhood eviction rates led to substantial declines in voter turnout. This study demonstrates that the impact of eviction reverberates far beyond housing loss, affecting democratic participation.


2021 ◽  
Vol 118 (32) ◽  
pp. e2108225118
Author(s):  
Madison Ashworth ◽  
Linda Thunström ◽  
Todd L. Cherry ◽  
Stephen C. Newbold ◽  
David C. Finnoff

The rapid development of COVID-19 vaccines is a tremendous scientific response to the current global pandemic. However, vaccines per se do not save lives and restart economies. Their success depends on the number of people getting vaccinated. We used a survey experiment to examine the impact on vaccine intentions of a variety of public health messages identified as particularly promising: three messages that emphasize different benefits from the vaccines (personal health, the health of others, and the recovery of local and national economies) and one message that emphasizes vaccine safety. Because people will likely be exposed to multiple messages in the real world, we also examined the effect of these messages in combination. Based on a nationally quota representative sample of 3,048 adults in the United States, our findings suggest that several forms of public messages can increase vaccine intentions, but messaging that emphasizes personal health benefits had the largest impact.


2019 ◽  
Vol 14 (2) ◽  
pp. 218-242 ◽  
Author(s):  
Laura Gasca Jiménez ◽  
Maira E. Álvarez ◽  
Sylvia Fernández

Abstract This article examines the impact of the anglicizing language policies implemented after the annexation of the U.S. borderlands to the United States on language use by describing the language and translation practices of Spanish-language newspapers published in the U.S. borderlands across different sociohistorical periods from 1808 to 1930. Sixty Hispanic-American newspapers (374 issues) from 1808 to 1980 were selected for analysis. Despite aggressive anglicizing legislation that caused a societal shift of language use from Spanish into English in most borderland states after the annexation, the current study suggests that the newspapers resisted assimilation by adhering to the Spanish language in the creation of original content and in translation.


2005 ◽  
Vol 30 (4) ◽  
pp. 987-1009
Author(s):  
George M. Sullivan

In two consecutive national elections a conservative, Ronald Reagan, was elected President of the United States. When Justice Lewis Powell announced his retirement during the late months of the Reagan administration, it was apparent that the President's last appointment could shift the ideology of the Court to conservatism for the first time since the presidency of Dwight Eisenhower. President Reagan's prior appointments, Sandra Day O'Connor and Antonin Scalia, had joined William Rehnquist, an appointee of President Nixon and Bryon White, an appointee of President Kennedy to comprise a vociferous minority of four in many instances, especially cases involving civil rights. The unexpected opportunity for the appointment of a conservative jurist caused great anxiety in the media and in the U.S. Senate, the later having confirmation power over presidential appointments to the Supreme Court. This article examines the consequences of the Senate's confirmation of Justice Anthony Kennedy to the Supreme Court. The impact, which was immediate and dramatic, indicates that conservative ideology will predominate on major civil rights issues for the remainder of this century.


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