El listado de pacientes en la empresa dedicada a la prestación de servicios médicos como objeto material de los delitos de descubrimiento y revelación de secretos de empresa / [The list of patients in the company dedicated to the provision of medical services as a material object of the crimes of discovery and disclosure of company secrets]

En la actualidad podría afirmarse que la mayor problemática existente en torno a los delitos de descubrimiento y revelación de secretos de empresa se encuentra en la indeterminación de su objeto material: el secreto de empresa. Esta indeterminación, que la reciente Ley 1/2019, de 20 de febrero, de Secretos Empresariales ayuda a solventar, ha llevado a los Tribunales de la jurisdicción penal a pronunciamientos dispares sobre la aplicación de los tipos penales relativos al descubrimiento y revelación de secretos de empresa, siendo uno de los supuestos más cuestionados en la práctica de nuestros Tribunales el tratamiento (o no) de un listado de clientes como un secreto de empresa. Si bien, hay muchas resoluciones que abogan por entender que dichos listados de clientes no forman parte de la información confidencial y reservada de una empresa –lo que impediría entenderla como un secreto de empresa–, encontramos también ejemplos de casos en los que se ha adoptado una solución contraria. Por medio del presente análisis, se pretende responder a la siguiente pregunta: ¿Puede un listado de pacientes ser considerado un secreto de empresa y, por tanto, dar lugar su descubrimiento y/o revelación a la comisión de un delito de los recogidos en el artículo 278 y siguientes del Código Penal? ¿Y si dicho listado de pacientes contuviera documentación clínica (con datos médicos) de cada uno de ellos? (AU)

Nowadays, the main problem with the offences of discovery and disclosure of trade secrets may lie in the indeterminacy of its material object: the business or trade secret. This indeterminacy, which the recent Law 1/2019, of 20 February, on Business Secrets helps to resolve, has led the Courts of the criminal jurisdiction to make disparate pronouncements on the application of criminal offences relating to the discovery and disclosure of business secrets, with one of the most questioned cases in the practice of our Courts being the treatment (or not) of a list of clients as a business secret. While there are many rulings that argue that such customer lists do not form part of the confidential and reserved information of a company –which would prevent it from being considered a trade secret–, there are also examples of cases in which the opposite solution has been adopted. This analysis aims to answer the following question: Can a list of patients be considered a business secret and, therefore, can its discovery and/or disclosure give rise to the commission of an offence under Article 278 et seq. of the Criminal Code? What if the list of patients contained clinical documentation (with medical data) for each of them? (AU)

Practice characteristics influencing variation in provision of depression care in general practice in Norway; a registry-based cohort study (The Norwegian GP-DEP study).

BACKGROUND: There is growing evidence of variation in treatment for patients with depression, not only across patient characteristics, but also with respect to the organizational and structural framework of general practitioners' (GPs') practice. However, the reasons for these variations are sparsely examined. This study aimed to investigate associations of practice characteristics with provision of depression care in general practices in Norway. METHODS: A nationwide cohort study of residents aged ≥ 18 years with a new depression episode in general practice during 2009-2015, based on linked registry data. Exposures were characteristics of GP practice: geographical location, practice list size, and duration of GP-patient relationship. Outcomes were talking therapy, antidepressant medication and sick listing provided by GP during 12 months from date of diagnosis. Associations between exposure and outcome were estimated using generalized linear models, adjusted for patients' age, gender, education and immigrant status, and characteristics of GP practice. RESULTS: The study population comprised 285 113 patients, mean age 43.5 years, 61.6% women. They were registered with 5 574 GPs. Of the patients, 52.5% received talking therapy, 34.1% antidepressant drugs and 54.1% were sick listed, while 17.3% received none of the above treatments. Patients in rural practices were less likely to receive talking therapy (adjusted relative risk (adj RR) = 0.68; 95% confidence interval (CI) = 0.64-0.73) and more likely to receive antidepressants (adj RR = 1.09; 95% CI = 1.04-1.14) compared to those in urban practices. Patients on short practice lists were more likely to receive medication (adj RR = 1.08; 95% CI = 1.05-1.12) than those on long practice lists. Patients with short GP-patient relationship were more likely to receive talking therapy (adj RR = 1.20; 95% CI = 1.17-1.23) and medication (adj RR = 1.08; 95% CI = 1.04-1.12), and less likely to be sick-listed (RR = 0.88; 95% CI = 0.87-0.89), than patients with long GP-patient relationship. CONCLUSIONS: Provision of GP depression care varied with practice characteristics. Talking therapy was less commonly provided in rural practices and among those with long-lasting GP-patient relationship. These differences may indicate some variation, and therefore, its reasons and clinical consequences need further investigation.

Algorithm linking patients and general practices in Denmark using the Danish National Health Service Register.

BACKGROUND: The patient list system in Denmark assigns virtually all residents to a general practice. Nevertheless, historical information on this link between patient and general practice is not readily available for research purposes. OBJECTIVES: To develop, implement, and evaluate the performance of an algorithm linking individual patients to their general practice by using information from the Danish National Health Service Register and the Danish Civil Registration System. MATERIALS AND METHODS: The National Health Service Register contains information on all services provided by general practitioners from 1990 and onward. On the basis of these data and information on migration history and death obtained from the Civil Registration System, we developed an algorithm that allocated patients to a general practice on a monthly basis. We evaluated the performance of the algorithm between 2002 and 2007. During this time period, we had access to information on the link between patients and general practices. Agreement was assessed by the proportion of months for which the algorithm allocated patients to the correct general practice. We also assessed the proportion of all patients in the patient list system for which the algorithm was able to suggest an allocation. RESULTS: The overall agreement between algorithm and patient lists was 98.6%. We found slightly higher agreement for women (98.8%) than for men (98.4%) and lower agreement in the age group 18-34 years (97.1%) compared to all other age groups (≥98.6%). The algorithm had assigned 83% of all patients in the patient list system after 1 year of follow-up, 91% after 2 years of follow-up, and peaked at 94% during the fourth year. CONCLUSION: We developed an algorithm that enables valid and nearly complete linkage between patients and general practices. The algorithm performs better in subgroups of patients with high health care needs. The algorithm constitutes a valuable tool for primary health care research.