Privacy and Confidentiality Practices in Adolescent Family Planning Care at Federally Qualified Health Centers
CONTEXT:
The
confidentiality of family planning services remains a high priority to
adolescents, but barriers to implementing confidentiality and privacy practices
exist in settings designed for teenagers who are medically underserved,
including federally qualified health centers (FQHCs).
METHODS:
A sample
of 423 FQHCs surveyed in 2011 provided information on their use of five
selected privacy and confidentiality practices, which were examined separately
and combined into an index. Regression modeling was used to assess whether
various state policies and organizational characteristics were associated with
FQHCs' scores on the index. In-depth case studies of six FQHCs were conducted
to provide additional contextual information.
RESULTS:
Among
FQHCs reporting on confidentiality, most reported providing written or verbal
information regarding adolescents' rights to confidential care (81%) and
limiting access to family planning and medical records to protect adolescents'
confidentiality (84%). Far fewer reported maintaining separate medical records
for family planning (10%), using a security block on electronic medical records
to prevent disclosures (43%) or using separate contact information for
communications regarding family planning services (50%). Index scores were higher
among FQHCs that received Title X funding than among those that did not
(coefficient, 0.70) and among FQHCs with the largest patient volumes than among
those with the smallest caseloads (0.43). Case studies highlighted how a lack
of guidelines and providers' confusion over relevant laws present a challenge
in offering confidential care to adolescents.
CONCLUSIONS:
The
organizational practices used to ensure adolescent family planning
confidentiality in FQHCs are varied across organizations.
- 1Department of Health, Educational Administration and Movement Studies, Central Washington University, Ellensburg, WA. tbeeson@cwu.edu.
- 2Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC.
- Perspect Sex Reprod Health. 2016 Feb 17. doi: 10.1363/48e7216.
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