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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: The Health Insurance Portability and Accountability Act (HIPAA) requires that health care institutions inform patients in detail about the use of information obtained during medical care via a notice of privacy form that "must be written in plain language."¹ We evaluated the length and readability of notice of privacy practices forms used by top-ranked US health care institutions.

Methods

Using institutional Web sites and electronic mail, we collected a notice of privacy practices from all 185 institutions listed in the 2004 US News & World Report’s "best hospitals" issue.² Readability indices use formulas combining word and sentence length to quantitate language complexity. Because there is no standard technique for determining readability, we used 3 different scales: SMOG,³ Flesch-Kincaid,⁴ and Flesch Reading Ease.⁵ The SMOG and Flesch-Kincaid scales produce an estimated educational level required to read and comprehend a document (reading grade level). Although the Flesch-Kincaid formula has . . . [Full Text of this Article]

Peter Breese, MSPH
peter.breese@dhha.org

William Burman, MD
Denver Public Health
Denver, Colo

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ABSTRACT