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Patient Privacy and Secondary Use of Administrative Databases

Sanjaya Kumar, MD, MSc, MPH; Charles Lucey, MD, JD, MPH
JAMA. 1996;276(14):1137-1138. doi:10.1001/jama.1996.03540140025014.
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To the Editor.  —We commend Mr Gostin1 for highlighting current issues and controversies regarding the acquisition, storage, and use of existing public health data. However, Gostin did not explicitly address how these state and federal statutes relate to the "secondary" use of administrative claims data such as Medicare data (Part A and B) and State Medicaid Management Information Systems databases, Veterans Affairs data, state repositories of data (Tumor Registry databases, Sudden Infant Death Syndrome database, and others), pharmaceutical databases, laboratory databases, and others. As of April 1996, a total of 38 states mandated the collection, analysis, and public dissemination of data from health care providers.2 These data contain potentially vast amounts of useful information for public health purposes on populations considered to be vulnerable. For example, to examine health status of nursing home residents, cost issues, quality of care concerns (eg, pressure ulcers, methicillin-resistant Staphylococcus aureus, or nosocomial


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