Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
Med Care. 2011 Feb;49(2):193-9. doi: 10.1097/MLR.0b013e3181f81edb.
Federal, provincial, and municipal organizations in Canada have recently begun to promote an equity agenda for their health systems, but much of the necessary data by which to identify those with social disadvantage are not currently collected.
We conducted a national survey of 1005 Canadian adults to assess the perceived importance of, and concern about, the collection of personal sociodemographic information by hospitals. We also examined public preference for practical approaches to the future collection of such information.
In this sample of Canadian adults, nearly half did not believe it was important for hospitals to collect individual-level sociodemographic data. The majority had concerns that the collection of these data could negatively affect their or others' care; this was especially true among visible minorities and those who have experienced discrimination. There was substantial variation across participant subgroups in their comfort with the collection of various types of information, but greater discomfort in general for current household income, sexual orientation, and education background. There was consistent discomfort reported from older participants. Participants in general were most comfortable providing this type of information to their family physician.
The importance of collecting patient-level equity-relevant data is not widely appreciated in Canada, and our survey has shown that concern about how these data could be misused are high, especially among certain subgroups. Qualitative research to further explore and understand these concerns, patient education about data usage and privacy issues, and using the family doctor's office as a linked electronic data collection point, will likely be important as we move toward high-quality equity measurement.
加拿大联邦、省和市级组织最近开始为其卫生系统推动公平议程,但目前尚未收集到确定社会弱势群体所需的大部分必要数据。
我们对 1005 名加拿大成年人进行了一项全国性调查,以评估他们对医院收集个人社会人口统计学信息的重要性和关注程度。我们还研究了公众对未来收集此类信息的实用方法的偏好。
在该加拿大成年人样本中,近一半的人认为医院收集个人社会人口统计学数据并不重要。大多数人担心收集这些数据可能会对他们或他人的护理产生负面影响;这在少数族裔和经历过歧视的人当中尤其如此。在不同的参与者亚组中,他们对收集各种类型信息的舒适度存在很大差异,但对当前家庭收入、性取向和教育背景的舒适度普遍较低。年龄较大的参与者报告的舒适度较低。参与者普遍更愿意向家庭医生提供此类信息。
在加拿大,收集与患者公平相关数据的重要性尚未得到广泛认可,我们的调查显示,人们对这些数据可能被滥用的担忧很高,尤其是在某些特定群体中。为了进一步探索和了解这些担忧,可以进行定性研究,对患者进行有关数据使用和隐私问题的教育,并利用家庭医生办公室作为电子数据收集点,这些都可能在我们迈向高质量公平衡量方面非常重要。