Concern about security and privacy, and perceived control over collection and use of health information are related to withholding of health information from healthcare providers

J Am Med Inform Assoc. 2014 Mar-Apr;21(2):374-8. doi: 10.1136/amiajnl-2013-002079. Epub 2013 Aug 23.


Introduction: This study assessed the perceptions and behaviors of US adults about the security of their protected health information (PHI).

Methods: The first cycle of the fourth wave of the Health Information National Trends Survey was analyzed to assess respondents' concerns about PHI breaches. Multivariate logistic regression was used to assess the effect of such concerns on disclosure of sensitive medical information to a healthcare professional (p<0.05).

Results: Most respondents expressed concerns about data breach when their PHI was being transferred between healthcare professionals by fax (67.0%; 95% CI 64.2% to 69.8%) or electronically (64.5%; 95% CI 61.7% to 67.3%). About 12.3% (95% CI 10.8% to 13.8%) of respondents had ever withheld information from a healthcare provider because of security concerns. The likelihood of information withholding was higher among respondents who perceived they had very little say about how their medical records were used (adjusted OR=1.42; 95% CI 1.03 to 1.96).

Conclusions: This study underscores the need for enhanced measures to secure patients' PHI to avoid undermining their trust.

Keywords: Protected health information; breaches; data; electronic; medical records; security.

MeSH terms

  • Adult
  • Aged
  • Attitude to Health*
  • Computer Security*
  • Confidentiality*
  • Electronic Health Records*
  • Female
  • Health Care Surveys
  • Humans
  • Information Dissemination
  • Logistic Models
  • Male
  • Middle Aged
  • Socioeconomic Factors
  • United States