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Regional Variations In Health Care Intensity And Physician Perceptions Of Quality Of Care [May 31, 2006] ASAHP Takes Action To Support Title VII Funding [May 30, 2006] Securing Health: Lessons From Nation-Building Missions [May 26, 2006] Cultural Competency: An E-Forum Roundtable Discussion [May 25, 2006] Possible Macroeconomic Effects Of A Potential Influenza Pandemic [May 24, 2006] Medical Screenings Performed, But Not Recommended [May 23, 2006] Commission On The Future Of Higher Education [May 22, 2006] Quality Improvement: Implications For Public Health Preparedness [May 19, 2006] 2005 Digest Of Education Statistics [May 18, 2006] Arming Health Care Consumers [May 17, 2006] Disparities In Health Care Spending [May 16, 2006] Health Care Spending And Use Of Information Technology [May 15, 2006] Trends In Health And Aging [May 12, 2006] Racial And Ethnic Differences In Insurance Coverage And Health Care Access And Use [May 11, 2006] Health Care Spending And Use Of Information Technology In OECD Countries [May 10, 2006] Patient-Centered Care For Underserved Populations: Definition And Best Practices [May 9, 2006] AHRQ Seeks Nominees For National Advisory Council [May 8, 2006] Snapshot Of U.S. College Students [May 5, 2006] Migration Patterns In The United States [May 4, 2006] Study Finds Middle-Aged Americans Less Healthy Than English Counterparts [May 3, 2006] Medicare Trust Funds To Be Depleted by 2018 [May 2, 2006] A Profile Of Frail Older Americans And Their Caregivers [May 2, 2006] Case Studies On Reducing Harm to Patients [May 1, 2006] Barriers Exist to Patient-Centered Care [April 18, 2006] Complementary And Alternative Medical Therapy Use Among Asian Americans [April 17, 2006] ACE Monograph Identifies Gaps In Research On Adult Learners [ April 14, 2006] Costs And Benefits Of Health Information Technology [April 13, 2006] CHEA Testimony Before Secretary Of Education's Commission On The Future Of Higher Education [April 12, 2006] Reports Available From The Secretary Of Education's Commission On The Future Of Higher Education [April 11, 2006] Update On The Quality Of American Health Care Through The Patient's Lens [April 10, 2006] State Support For College Students At 25-Year Low [April 7, 2006] Framework For Initiating Private And Secure Health Information Sharing [April 6, 2006] Electronic Personal Health Records: Lessons From Abroad [April 5, 2006] Arthritis Care For Older Patients Is Poor [April 4, 2006] Case Studies In Safety Improvement [April 3, 2006] Regional Variations In Health Care Intensity And Physician Perceptions Of Quality Of Care The May 2 issue of the Annals of Internal Medicine contains an article (pp. 641-649) by Sirovich, et al, which indicates that U.S. physicians in areas of high health care intensity feel no better able to provide quality care than those in low-intensity areas. Despite having access to one-third more beds per capita, these physicians reported greater difficulty hospitalizing their patients than those in low-intensity regions. Although high-intensity regions had over 60% more medical subspecialists, physicians in these areas were the least satisfied with the accessibility and quality of specialty referrals. Furthermore, high-intensity regions had the highest physician-to-patient ratios but physicians in these regions felt the least able to maintain high-quality relationships with patients. Finally, physicians in high-intensity regions felt the least able to provide high-quality care and were the least satisfied with their careers. The authors indicate that the findings are relevant to current policy debates. Even the possibility that higher health care intensity, itself closely related to greater physician supply, could lead to lower quality of care underscores the importance of proceeding carefully with decisions about further expansion of the physician workforce. The findings also indicate that concerns that physicians in lower-intensity regions have inadequate local resources and are more dissatisfied with their careers are misplaced. Further research to learn from the practice patterns in lower-intensity regions may offer important insights into efforts to improve the quality of health care and to control the growth of health care spending. ASAHP Takes Action To Support Title VII Funding Members of the Association of Schools of Allied Health Professions (ASAHP) have been contacted with a request to support an increase in appropriations for Title VII of the Public Health Service Act. The main source of federal funding for health professions education, spending was cut 52 percent for the current fiscal year. ASAHP and other groups are working to have funding restored to the previous fiscal year's level. The cuts resulted in the elimination of several important programs, while others were decimated heavily. The Association will send a letter to key legislators, indicating why it is necessary to provide federal support for health professions education. Activities funded under this legislation have been successful in recent years in increasing the number of health professionals who work in underserved areas and in attracting more minority and disadvantaged persons to the health professions. Given the aging of the population and the changing demographics regarding ethnicity, efforts must continue to produce a health workforce that is capable of meeting these challenges. ASAHP's homepage contains a sample Op-Ed piece that members can send directly to media outlets as a means of increasing public visibility of the importance of maintaining governmental support for health professions education. Securing Health: Lessons From Nation-Building Missions Rebuilding public health and health care delivery systems has been an important component of nation-building efforts conducted after major conflicts. However, few studies have attempted to examine a comprehensive set of cases, compare the quantitative and qualitative results, and outline best practices. A study from RAND assesses seven cases of nation-building operations following major conflicts: Germany and Japan immediately after World War II; Somalia, Haiti, and Kosovo in the 1990s; and Afghanistan and Iraq since 2001. It concludes that two factors increase the likelihood of successful health outcomes: planning and coordination, and infrastructure and resources. In addition, the study argues that health can have an independent impact on broader political, economic, and security objectives during nation-building operations. The report can be accessed by clicking http://www.rand.org/pubs/monographs/2006/RAND_MG321.pdf . Cultural Competency: An E-Forum Roundtable Discussion The Commonwealth Fund hosted the roundtable, "Cultural Competency: Understanding the Present and Setting Future Directions," in New York City on April 7, bringing together researchers, providers, policymakers, and others to discuss cultural competency research, practice, and measurement. Presentations can be accessed by clicking http://www.cmwf.org/topics/topics_show.htm?doc_id=373785 Possible Macroeconomic Effects Of A Potential Influenza Pandemic In December 2005, at the request of the Senate Majority Leader, the Congressional Budget Office (CBO) prepared an assessment of the possible macroeconomic effects of an avian flu pandemic. In its assessment, CBO also described the nation's preparedness for a pandemic and options for increasing preparedness. At the request of the Majority Leader and the Chairman of the Senate Budget Committee, CBO updated to its earlier work, focusing on changes in the budgetary and economic aspects of the nation's preparedness. Medical Screenings Performed, But Not Recommended The June 2006 issue of the American Journal of Preventive Medicine (pages 521-527) contains a report of a cross-sectional study in 2005 of office-based interventions using National Ambulatory Medical Care Survey (NAMCS) data from 1997 to 2002. Recommendations from the United States Preventive Services Task Force (USPSTF) were used as a measure of appropriateness of diagnostic interventions during the PHE. Laboratory tests and procedures not recommended (D ranking) included urinalysis (UAs); interventions not recommended included electrocardiograms (EKGs) and x-rays. Commission On The Future Of Higher Education The Commission on the Future of Higher Education met in Washington, DC on May 18 and 19. Plans are underway to draft a final series of recommendations in a report due to be sent to Department of Education Secretary Margaret Spellings sometime in September. The commission is made up of representatives from higher education, business, and foundations. The group is examining ways to ensure that U.S. colleges and universities remain globally competitive and continue to meet the needs of students and families. Quality Improvement: Implications For Public Health Preparedness Recent events, such as the terrorist attacks of September 11, 2001, the anthrax attacks, the flu vaccine shortage of 2004–2005, and the response to Hurricane Katrina, have all rekindled interest in strengthening the nation's public health infrastructure and, in particular, have shown the importance of public health emergency preparedness (PHEP). To enhance the public health system and address gaps in preparedness, the U.S. government has spent billions of dollars since September 2001 to introduce surveillance systems, purchase equipment, and develop plans and measures. Despite these efforts, concerns remain about the ability of the public health system to respond to emergencies. Federal and state budget deficits strain the current system, while changes in the health care delivery system and ambivalence about the role of government have resulted in relatively low expectations for public health and what it can achieve. Standards for defining and measuring preparedness are lacking, and there are few measures with which to assess the performance—and progress—of health departments in emergency preparedness or to implement systematic change. Adding to these challenges is the complexity of the public health system itself, which includes thousands of county and city health departments; local boards of health; state and territorial health departments; tribal health departments; public and private laboratories; parts of multiple federal departments and agencies; hospitals and other health care providers; volunteer organizations, such as the Red Cross (Lister, 2005); and private vaccine and drug manufacturers and distributors. Moreover, the broad mission of public health, which extends from the promotion of physical and mental health to disease prevention, means that emergency preparedness must compete with many other programs and activities. The report may be accessed by clicking 2005 Digest Of Education Statistics The Digest of Education Statistics provides a compilation of statistical information covering the broad field of American education from prekindergarten through graduate school. It includes a selection of data from many sources, both government and private, and draws especially on the results of surveys and activities carried out by the National Center for Education Statistics (NCES). The publication contains information on a variety of subjects in the field of education statistics, including the number of schools and colleges, teachers, enrollments, and graduates, in addition to educational attainment, finances, federal funds for education, libraries, and international education. Supplemental information on population trends, attitudes on education, education characteristics of the labor force, government finances, and economic trends provides background for evaluating education data. Portions of the report covering postsecondary education may be accessed by clicking http://nces.ed.gov/programs/digest/d05/lt3.asp#17 . Last month, Carolyn Clancy, Director of the Agency for Healthcare Research and Quality, testified before the Joint Economic Committee of the U.S. Congress. Her purpose was to discuss the agency's efforts to enable consumers to have the information and tools they need to make the health care choices that are right for them. Her testimony recently became available and can be accessed by clicking Disparities In Health Care Spending A report on differences in the management of Medicare enrollees with severe chronic illnesses was released today. The focus is on the care of Medicare beneficiaries with one or more of twelve chronic illnesses that account for more than 75% of all U.S. health care expenditures. Among persons who died between 1999 and 2003, per capita spending varied by a factor of six between hospitals across the country. Average utilization and spending varied from state to state, from region to region within states, and from hospital to hospital within the same regions. Spending was not correlated with rates of illness in different parts of the country; rather, it reflected how intensively certain resources - acute care hospital beds, specialist physician visits, tests and other services - were used in the management of patients who were very ill. The report from Dartmouth Medical School can be accessed by clickinghttp://www.dartmouthatlas.org/atlases/2006_Chronic_Care_Atlas.pdf . Health Care Spending And Use Of Information Technology According to an article in the May/June 2006 issue of Health Affairs, in 2003, the United States had fewer practicing physicians, practicing nurses, and acute care bed days per capita than the median country in the Organization for Economic Cooperation and Development (OECD). Nevertheless, U.S. health spending per capita was almost two and a half times the per capita health spending of the median OECD country. One proposal for both lowering health spending and improving quality is the adoption of health information technology (HIT). The United States lags as much as a dozen years behind other industrialized countries in HIT adoption—countries where national governments have played major roles in establishing the rule, and health insurers have paid most of the costs. The article may be accessed by clicking The National Center for Health Statistics (NCHS) has a site on the Web that contains tables on trends in the health of older Americans showing data by age, sex, race and Hispanic origin. The tables are easy to customize. The site may be accessed by clicking http://www.cdc.gov/nchs/agingact.htm . Racial And Ethnic Differences In Insurance Coverage And Health Care Access And Use Several studies conducted as part of the Urban Institute's Assessing the New Federalism project have focused on documenting and explaining racial and ethnic differences in insurance coverage and health care access and use. ANF's National Survey of America's Families has enabled studies of trends in insurance coverage gaps, analyses of under-studied populations, and multivariate decompositions of the factors related to racial and ethnic differences. This paper reviews those studies and highlights their contribution to the large and growing literature regarding racial and ethnic differences. It supplements the review with findings from the authors' analyses of the 2002 NSAF. The paper may be accessed by clicking http://www.urban.org/UploadedPDF/311321_DP06-01.pdf . Health Care Spending And Use Of Information Technology In OECD Countries U.S. health spending per capita significantly and consistently outpaces that of other industrialized nations. One proposal for lowering health spending and improving quality is the adoption of health information technology (HIT), yet the United States lags behind other countries by as much as a dozen years in its efforts to implement HIT. Heeding lessons from their experiences with HIT development could facilitate U.S. implementation, finds a new analysis supported by The Commonwealth Fund. In "Health Care Spending and Use of Information Technology in OECD Countries,” ( Health Affairs, May/June 2006) the authors present U.S. spending and HIT initiatives within an international context. They also discuss the key issues surrounding HIT implementation: creating incentives, ensuring interoperability, and easing the public's privacy concerns. The article may be accessed by clicking Patient-Centered Care For Underserved Populations: Definition And Best Practices Prepared by the Economic and Social Research Institute for the W.K. Kellogg Foundation, a new report defines key components of patient-centered care for diverse, vulnerable populations and describes how such care is being put into practice across the country. A particular focus is on serving individuals who typically face obstacles to appropriate health care related to language, culture, education, age, and economic status. By improving the patient and clinician experience, and enhancing the patient's understanding of and role in his/her care, these practices can improve the effectiveness of health care delivery and reduce disparities. In addition to the overview, five case studies highlight successful and innovative strategies at select hospital systems and community health centers. The case studies describe the institutional supports and structures necessary to provide patient-centered care and present concrete practices that could be replicated in a wide range of health care and social service settings. The report also presents policy recommendations that could promote the development, adoption, and expansion of such effective strategies. The report may be accessed by clicking http://www.esresearch.org/documents_06/Overview.pdf . AHRQ Seeks Nominees For National Advisory Council 42 U.S.C. 299c, section 931 of the Public Health Service (PHS Act), established a National Advisory Council for Healthcare Research and Quality. The Council is to advise the Secretary of HHS and the Director of the Agency for Healthcare Research and Quality (AHRQ) on matters related to actions of the Agency to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. Eight current members' terms will expire in November 2006. To fill these positions in accordance with the legislative mandate establishing the Council, we are seeking individuals who are distinguished: (1) In the conduct of research, demonstration projects, and evaluations with respect to health care; (2) In the fields of health care quality research or health care improvement; (3) In the practice of medicine; (4) In other health professions; (5) In representing the private health care sector (including health plans, providers, and purchasers) or administrators of health care delivery systems; (6) In the fields of health care economics, information systems, law, ethics, business, or public policy; and, (7) In representing the interests of patients and consumers of health care. Individuals are particularly sought with experience and success in activities specified in the summary above. Nominations should be received on or before June 14, 2006 and sent to Ms. Deborah Queenan, AHRQ, 540 Gaither Road, Room 3238, Rockville, Maryland or sent by FAX to (301) 427-1341. She may be contacted at Tel: 301-427-1330. Snapshot Of U.S. College Students Twelve percent of all undergraduate students in the United States are first-generation Americans and 39 percent of undergraduates in the United States are aged 25 or older. These are just two of the fast facts offered in a new publication by the Center for Policy Analysis at the American Council on Education (ACE). College Students Today: A National Portrait uses data from the Department of Education's National Postsecondary Student Aid Study, 2003-04. It provides readers with statistics on the U.S. college student population including the percentage of male and female undergraduates, students of color, adult students, international students, low-income students, and undergraduates with foreign-born parents. It also includes useful data on graduate and professional students in the United States. Copies can be ordered at a cost of $25 each by clicking Migration Patterns In The United States Migration is playing a larger role in population redistribution within the United States. With birth and death rates currently low and largely similar across the country, natural increase (the excess of births over deaths) exerts less influence than it used to in explaining why some regions, states, or counties have faster population growth than others. Population changes both in actual numbers and in percentages by age cohort exert a significant effect on the kinds and amounts of health services required. The educational system also is affected by these same factors from the standpoint of producing health professionals to fill available positions. The migration story at this broad geographic level is one of net out-migration from the Northeast and the Midwest and net inmigration to the South. Within the Northeast, New England continued to experience net outmigration between 2000 and 2004, but at lower levels than during the 1990s. Within the West, net inmigration continued to the Mountain division and net out-migration occurred from the Pacific division; in both cases, these trends moderated from the 1990s' pace. The South continued to have the most net inmigration of any region, due to the continued higher levels of net inmigration to the South Atlantic division. Florida had the largest annualized amount of net inmigration during 2000–2004, averaging 191,000 per year (Figure 1). Arizona (66,000) and Nevada (51,000) were second and third, respectively. Of the 10 states with the largest annualized net migration amounts for the period, 7 are located in the South and 3 are located in the West. For additional information, click http://www.census.gov/prod/2006pubs/p25-1135.pdf . Study Finds Middle-Aged Americans Less Healthy Than English Counterparts Middle-aged Americans are less healthy than their English counterparts, according to a study issued by researchers from the RAND Corporation, University College London and the Institute for Fiscal Studies in London. Analyzing surveys of large groups of middle-aged individuals from the United States and England, researchers found that Americans ages 55 to 64 suffer from diseases such as diabetes, high-blood pressure, and lung cancer at rates up to twice those seen among similar aged persons in England. The prevalence of diabetes was twice as high in the United States (12.5 percent) as compared to England (6.1 percent), while high blood pressure was about 10 percentage points higher in the United States than in England. Heart disease was 50 percent more common among middle-aged Americans than the English, while the rates of stroke, lung disease and cancer were higher among Americans as well. The differences were confirmed when researchers analyzed separate studies that collected blood samples from participants to look for biological markers of disease. This showed that the differences were not just a result of Americans' increased willingness to report illness. The study appears in the May 3 edition of the Journal of the American Medical Association. Medicare Trust Funds To Be Depleted by 2018 The Medicare hospital trust fund will become insolvent in 2018, two years earlier than was predicted last year, according to the 2006 annual report by Medicare trustees. Medicare's hospital expenses will exceed its income by 2010. By 2018, the trust fund will be able to cover only 80% of estimated billings for inpatient care. Beyond 2018, the condition of the trust fund will decline rapidly. The report may be accessed by clicking A Profile Of Frail Older Americans And Their Caregivers A new study from the Urban Institute highlights several policy issues, including the limited government support for long-term care services to older Americans living at home. Six times as many older persons with disabilities live at home as in nursing homes, yet two-thirds of long-term care expenditures for the aged go to institutional care. Long-term care is a women's issue . Women account for most older individuals who receive care and most of their caregivers. Nearly two-thirds with severe disabilities are female. Women account for about two-thirds of all unpaid caregivers. Daughters account for about 7 of every 10 adult children who help their frail parents and about five of every six who assume primary responsibility for their personal care. The aging of the baby boomers will likely intensify long-term care demands on government and families . Between 2000 and 2050, the size of the population age 85 and older will soar from 4.3 million to 20.9 million, increasing the number of people in need of care. The availability of family caregivers may also decline over time because of rising divorce rates, increasing childlessness, declining family sizes, and rising employment rates of married women. Additional support for home- and community-based care is likely to be necessary to keep many frail older. The report may be accessed by clicking http://www.urban.org/UploadedPDF/311284_older_americans.pdf Case Studies On Reducing Harm to Patients A new report presents 10 case studies of health care organizations, clinical teams, and learning collaborations that have designed innovations in five areas that hold great promise for improving patient safety nationally: promoting an organizational culture of safety, improving teamwork and communication, enhancing rapid response to prevent heart attacks and other crises in the hospital, preventing health care–associated infections in the intensive care unit, and preventing adverse drug events throughout the hospital. Participating organizations ranged from large integrated delivery systems to small community hospitals. The cases describe the actions taken, results achieved, and lessons learned by these patient safety leaders, with suggestions for those seeking to replicate their successes. The study was supported by funding from The Commonwealth Fund. The report may be accessed by clicking: Barriers Exist to Patient-Centered Care Less than one-quarter of primary care physicians are achieving the highest levels of patient-centered care in their daily practices, according to findings published in the April 10, 2006 issue of the Archives of Internal Medicine . The study, compiled by Commonwealth Fund researchers, found a gap between attitudes and behavior in the area of patient-centered care. Eighty-seven percent of primary care physicians support improved teamwork between physicians and other medical professionals to improve patient care, while 83 percent of primary care physicians surveyed agreed that patients should have access to their own medical records. But the report concludes that just 16 percent of primary care physicians use e-mail to communicate with their patients and 12 percent said they planned to use e-mail with their patients in the next year. About three-quarters of primary care physicians surveyed have experienced some problems with the availability of patients' medical records, test results, or other relevant information at the time of a scheduled visit, and slightly less than half, or 48 percent, sent patients reminder notices about regular preventive or follow-up care. Primary care physicians surveyed said they faced significant barriers to adopting more practices to improve patient-centered care. According to the survey, 63 percent of physicians reported that training and knowledge stopped them from implementing patient-centered practices while 84 percent cited cost as a barrier. Areas for improvement include using more information technology, team-based care, and collecting feedback from patients. Complementary And Alternative Medical Therapy Use Among Asian Americans A Commonwealth Fund-supported study entitled, " Complementary and Alternative Medical Therapy Use Among Chinese and Vietnamese Americans: Prevalence, Associated Factors, and Effects of Patient-Clinician Communication, " which appears in the April issue of the American Journal of Public Health explores the relationship among use of complementary and alternative medical (CAM) therapies, patient-clinician communication, and patients' satisfaction with care. Although few patients discussed their use of CAM therapies with their doctors, those who did reported better overall quality of care, the study found. ACE Monograph Identifies Gaps In Research On Adult Learners A new monograph from the Center for Policy Analysis and the Center for Lifelong Learning at the American Council on Education (ACE) summarizes the data and research currently available on the 6.5 million adults over the age of 25 who are enrolled in postsecondary education. In Adult Learners in the United States: A National Profile , the authors found significant gaps in the knowledge base on adult learners. For example, they found no data on the majors of adult learners. Additional gaps in existing research include noncredit enrollment and what Paulson and what's called “the paucity of research on campus practices that can help adult learners reach their educational goals.” Copies can be ordered online at http://www.acenet.edu/bookstore/pubInfo.cfm?pubID=370 . Costs And Benefits Of Health Information Technology The Agency for Healthcare Research and Quality (AHRQ) released a report earlier this week acknowledging that while health information technology has been shown to improve quality of care for patients, most health care providers need more information about how to implement these technologies successfully. AHRQ is helping to fill this gap with findings from more than 100 projects across the country. These projects make up AHRQ's $166 million health IT initiative. The report, Costs and Benefits of Health Information Technology , is a synthesis of studies that have examined the quality impact of health IT as well as the costs and organizational changes needed to implement health IT systems. This report reviews scientific data about the implementation of health IT to date, as documented in studies published through 2003. It does not project future health care benefits or savings, in contrast to other reports. The report may be accessed by clicking CHEA Testimony Before Secretary Of Education's Commission On The Future Of Higher Education Judith Eaton, President of the Council for Higher Education Accreditation (CHEA), testified nationally April 6 on issues ranging from accreditation, accountability, and quality assurance before “A National Dialogue: The Secretary of Education's Commission on the Future of Higher Education,” held in Indianapolis, Indiana. CHEA is the nation's largest institutional higher education membership organization, with 3,000 colleges and universities. It is a private, nonprofit national organization that coordinates accreditation activity in the U.S. She spoke in strong opposition to new efforts by the Commission to promote a “National Accreditation Foundation” to take over the role of evaluating higher education institutions from private accrediting organizations. This effort, Eaton and others suggest, would be incompatible with a voluntary, autonomous, and self-regulatory system. She testified in support of the current accreditation process while calling for reforms in accountability and transparency to bolster that process. Her testimony can be accessed by clicking http://www.chea.org/Government/Testimony/Futures0406.pdf . Reports Available From The Secretary Of Education's Commission On The Future Of Higher Education The Secretary of Education's Commission on the Future of Higher Education has produced several papers in recent months on the following kinds of topics: college costs, affordability, federal financial aid, accountability/assessment, accreditation, and quality. The Commission website may be accessed at Update On The Quality Of American Health Care Through The Patient's Lens U.S. health care leaders often say that American health care is the best in the world. However, recent studies of medical outcomes and mortality and morbidity statistics suggest that, despite spending more per capita on health care and devoting to it a greater percentage of its national income than any other country, the United States is not getting commensurate value for its money. The Commonwealth Fund's cross-national surveys of patients' views and experiences of their health care systems offer opportunities to assess U.S. performance relative to other countries through the patients' perspective—a dimension often missing from international comparisons. In 2004, U.S. performance was reported using Commonwealth Fund international survey data from 2001 and 2002. This report updates these findings using data from two recent surveys. The first survey was conducted in 2004 among a nationally representative sample of adults in five nations: Australia, Canada, New Zealand, the United Kingdom, and the United States. The second survey was conducted in 2005 among a sample of adults with health problems in the same five nations and Germany. This report ranks the countries on patients' reports on care experiences and ratings on various dimensions of care. While focusing on a limited slice of the health care quality picture—patient perceptions of care received—as well as a limited number of countries, the surveys nonetheless offer valuable insights. The report may be accessed by clicking http://www.cmwf.org/usr_doc/Davis_mirrormirror_915.pdf State Support For College Students At 25-Year Low Although state and local funding per student increased 3.5 percent last year, constant dollar funding for college and university students was at its lowest in 25 years, according to the annual study of state higher education finance recently released by the association of State Higher Education Executive Officers (SHEEO). State and local support for public institutions was $5,833 per student during 2004-05, down from a 25-year high in fiscal 2001 of $7,121. The report, State Higher Education Finance FY 2005 , reveals that support per student decreased dramatically from 2001 to 2005 because enrollment grew by 14.3 percent and inflation grew by 14.2 percent without corresponding increases in public funding. State and local support, effectively flat from 2001 to 2004, grew by 3.5 percent in 2005, but this increase was exceeded by the combined effects of a 2.1 percent growth in enrollment and a 3.4 percent increase in inflation. As a result, state and local government support per student decreased 1.9 percent in 2005. The study indicates that while funding for higher education remains a priority for most states, total tax revenues have decreased as a percentage of state wealth, thus decreasing overall support. However, the report's authors say that the decline in state support per student reflects a "historical pattern:" State revenues fall and higher education enrollments grow during a recession, and for a variety of reasons, higher education is often at the top of the list of funding cuts. The report may be accessed by clicking http://www.sheeo.org/finance/shef_sv06_v2.pdf . Framework For Initiating Private And Secure Health Information Sharing Connecting for Health, a public-private collaborative of more than 100 organizations, today released its Common Framework: Resources for Implementing Private and Secure Health Information Exchange . The Common Framework provides the initial elements of a comprehensive approach for secure, authorized, and private health information sharing, so that patients and their authorized providers can have access to vital clinical data when and where they are needed. This capability is essential for providing high-quality care and reducing medical errors. The Common Framework includes 16 technical and policy components, which were developed by experts in information technology, health privacy law, and policy. This initial set of critical technical and policy components demonstrates how various health information networks can share information while protecting privacy and allowing for local autonomy and innovation. The components being released today include technical documents and specifications, testing interfaces, and code, as well as a companion set of privacy and security policies and model contractual language to help organizations interested in information exchange move quickly towards the necessary legal agreements for private and secure health information sharing. The components were tested since mid-2005 by Connecting for Health teams in Indianapolis, Boston, and Mendocino County, Calif., the three communities in which the prototype was developed. All the Connecting for Health Common Framework materials can be accessed by clicking www.connectingforhealth.org . Electronic Personal Health Records: Lessons From Abroad Don Detmer, President and Chief Executive Officer of American Medical Informatics Association discusses approaches to the evolving technology of personal health records in Australia, Canada, England, and New Zealand. Arthritis Care For Older Patients Is Poor The quality of medical care received by older persons with arthritis is relatively poor and they receive recommended information about potential hazards of their medication less than half the time, according to a RAND Corporation study issued today. In the first study to measure the quality of arthritis care based on patient interviews, researchers from RAND Health. the David Geffen School of Medicine at UCLA and the Greater Los Angeles VA Healthcare System found that older patients received the recommended care for arthritis just 57 percent of the time. Researchers found that failing to inform patients about medication safety was the most severe quality problem. Just 44 percent of the patients studied received the recommended information about the safety of their medication. In contrast, 64 percent had received some treatment for their arthritis. The study is titled “Quality of Osteoarthritis Care for Community-Dwelling Older Adults” and is published in the April edition of the journal Arthritis Care & Research. Case Studies In Safety Improvement In the March 2006 issue of the Milbank Quarterly , an article entitled "Stories from the Sharp End: Case Studies in Safety Improvement” provides a snapshot of promising techniques for stimulating cultural change within health care organizations. The case studies demonstrate that patient injuries are not an inevitable side effect of care. A culture of safety does not just evolve, it is actively created.
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