WASHINGTON —— Most American consumers are worried about the privacy of their health records, according to a national survey conducted by the California HealthCare Foundation.

The survey, completed last summer by 2,000 participants, found that 67 percent of people are concerned about the privacy of their medical records. Half of the participants were California residents.

Local medical experts say stronger health care privacy regulations passed in 2003 have made medical information more safe and private, and that consumers' fears that their health records will be misused are generally unwarranted.

Still, the survey showed consumers worry about misuse of medical records by employers and about identity theft from medical records. A fear of losing privacy has caused patients to ask their doctor to refrain from reporting a health condition, pay out of pocket for procedures, and even stop going to the doctor altogether, according to survey results.

"Technology alone is not all there is to privacy and security. And the public knows that," said Bradford Holmes, research director at Forrester Research Inc. "There are people involved and process involved. People and process can break down."

In April 2003, the Department of Health and Human Services implemented stricter privacy measures through the federal Health Insurance Portability and Accountability Act.

Many health care privacy issues have been resolved by the act, "but people don't realize it," said Joseph Scherger, chairman of communications for the San Diego County Medical Society.

Scherger said the public needs to be encouraged to check out HIPAA's Web site at www.hipaa.org.

In 2003, the government sent information to households nationwide about citizens' rights and protections under the act.

Since the mailings, there have been 15,000 privacy complaints filed with the government, according to Sam Karp, chief program officer of the California HealthCare Foundation. Karp said there has not been one civil prosecution.

He also said people need to be careful of what they sign. They may be giving out access to private records without knowing it.

Kim Jackson, the director of Health Information Services at Palomar Pomerado Health, said the hospital district tries to educate patients about their rights during the registration process. The district does not often receive complaints about privacy, and any complaints are addressed right away, Jackson said.