A national survey of physicians regarding protection of patient privacy in China

Objectives: The significance of safeguarding patient privacy at a population level within public medical institutions remains insufficiently acknowledged despite the potential to enhance the protection awareness of physicians and of hospital management in clinical practice. We herein devised a survey to investigate the current state of patient privacy breaches in China and to ascertain its underlying rationales. Methods: We conducted a comprehensive nationwide survey of 928 physicians in seven geographic regions of China through convenience and snowball sampling, enrolled physicians defined in the Chinese Health Statistics Yearbook, and measured the incidence of medical data breaches. Physicians' perceptions and behaviors with respect to patient privacy protection and their attitudes toward hospital management were accessed through descriptive statistics. Multiple logistic regression analysis was also conducted with different adjustments of covariates for each model. Results: Of the 937 respondents, 928 physicians were eligible and validated for the analysis. We estimated that 52.2 % (95 %CI, 48.9-55.4) of the physicians reported that they had disclosed their patients' privacy. Master's (OR, 0.63 [95 %CI, 0.43-0.92]) and Ph.D. (OR, 0.59 [95 %CI, 0.35-1.00]) educational levels, scores on the understanding of patient privacy protection (OR, 0.89 [95 %CI, 0.80-0.99]), the presence of colleagues who had experienced data disclosure (OR, 7.00 [95 %CI, 5.02-9.77]), full-time department supervision (OR, 1.60 [95 % CI, 1.02-2.53]) and corresponding regulations (OR, 0.56 [95 %CI, 0.33-0.97]) for patient privacy protection in the hospital, restricted external equipment for computers (OR, 1.76 [95 %CI, 1.10-2.83]), and access to medical records (OR, 0.62 [95 %CI, 0.41-0.94]) were all associated with privacy breaches by physicians. Conclusions: In general, patient privacy research and awareness of patient privacy protection are relatively deficient in China, with a remarkably high occurrence of disclosure. We posit that the identification of the factors underlying our results will provide evidence for appropriate hospital management, and that these factors may then be generalizable to other clinical settings. Public interest summary: Patient privacy breaches seem to be rarely mentioned and addressed regardless of the country, potentially due to its high sensitivity, while this is significant in clinical practice. In this study, we meant to find out the answers to the questions, "What is the situation of privacy disclosure in China public medical institutions?", "Why does it happen?", and "Is patient privacy protected enough? If not, how can we do better?". Through conducting a survey among physicians, their answers were collected for further analysis. Our results appear to provide guidance for physicians on patient privacy protection and support hospital and information management.