Patients rarely detect breaches of confidence

Abstract

Objective:To measure the prevalence of patient reported breaches of confidence emanating from health services inSouth Australia.Methods:A community household survey with follow up telephone interviews of those reporting unauthorised disclosures.Recruitment interviews were conducted during October and November 2001 with 3037 South Australian residentsover 15 years of age. South Australian households were selected randomly within a representative selection of censuscollection districts. Follow up telephone interviews were conducted with 18 respondents who reported unauthorisedinformation releases in the twelve months prior to the initial survey.Results:The one year prevalence of breaches of confidence reported by patients was 0.23 +/- 0.17% (1.96 x SE).This prevalence was significantly lower than a previously published estimate (Mulligan, 2001) of 1.1 +/- 0.4%(difference between proportions p= 0.003, z= 4.415) which relied upon reports of information disclosed without thepatients permission as a proxy for breaches of confidence.An incidental finding was that 0.20+/- 0.16% (1.96 x SE) of respondents reported exchanges of information amongstmembers of treating teams which had not been authorised by the patient.Conclusion:True breaches of confidence arising from health care interactions are rarely detected by patients. Ordinary informationsharing within treating teams may be a more important source of misunderstandings between patients and health careproviders. This issue can be addressed at the point of care by informing patients what will be done with their healthinformation and who may later gain access to it.