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美国中西部农村地区的伦理委员会:探究《健康保险流通与责任法案》的影响

Ethics committees in the rural Midwest: exploring the impact of HIPAA.

作者信息

Having Karen M, Hale Dena, Lautar Charla J

机构信息

School of Allied Health, College of Applied Sciences and Arts, Southern Illinois University Carbondale, Carbondale, Illinois 62901, USA.

出版信息

J Rural Health. 2008 Summer;24(3):316-20. doi: 10.1111/j.1748-0361.2008.00175.x.

Abstract

CONTEXT

Confidentiality of personal health information is an ethical principle and a legislated mandate; however, the impact of the Health Insurance Portability and Accountability Act (HIPAA) on ethics committees ethics committees is limited.

PURPOSE

This study investigates the prevalence, activity, and composition of ethics committees located in rural central and southern Illinois. Additionally, the impact of the HIPAA Officer serving on the committee is reported.

METHODS

Surveys were mailed to the "Administrator or Ethics Committee Chairperson" at rural Illinois hospitals and skilled care facilities. Survey items included committee composition and perception of HIPAA-related involvement.

FINDINGS

Over one third (36.7%) of the facilities reported having formal ethics committees. Hospitals were more likely (79.3%) to have ethics committees than skilled nursing facilities (20.7%). Ethics committee members usually include an administrator, nurse, and physician. The smaller the facility (based on number of beds), the more likely it was to have a HIPAA Officer on the committee. Committees with a HIPAA Officer were more likely to be involved in monitoring and/or remediation of HIPAA privacy and security violations. Most respondents, however, did not feel the committee should be involved in these issues.

CONCLUSIONS

Although the sample size is too small to generalize, HIPAA does seem to have an effect on the issues discussed by ethics committees. Furthermore, ethics committees that include a HIPAA Officer in the membership report increased committee involvement in HIPAA related issues.

摘要

背景

个人健康信息的保密性是一项伦理原则和法定要求;然而,《健康保险流通与责任法案》(HIPAA)对伦理委员会的影响有限。

目的

本研究调查了伊利诺伊州中部和南部农村地区伦理委员会的普遍性、活动情况和组成。此外,还报告了担任委员会成员的HIPAA官员的影响。

方法

向伊利诺伊州农村医院和专业护理机构的“管理人员或伦理委员会主席”邮寄调查问卷。调查项目包括委员会组成以及对与HIPAA相关参与情况的看法。

结果

超过三分之一(36.7%)的机构报告设有正式的伦理委员会。医院比专业护理机构更有可能(79.3%)设有伦理委员会(20.7%)。伦理委员会成员通常包括一名管理人员、一名护士和一名医生。机构规模越小(以床位数计),其委员会中设有HIPAA官员的可能性就越大。设有HIPAA官员的委员会更有可能参与监测和/或纠正HIPAA隐私和安全违规行为。然而,大多数受访者认为委员会不应参与这些问题。

结论

尽管样本量太小无法进行推广,但HIPAA似乎确实对伦理委员会讨论的问题产生了影响。此外,成员中包括HIPAA官员的伦理委员会报告称,委员会在与HIPAA相关问题上的参与度有所提高。

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