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Care Guidelines Must Consider Benefits, Costs
A five-country study quantifying differences in national guidelines for preventing cardiovascular disease reveals wide variance in the overall costs and health consequences of these policies. The most cost-effective guidelines focus on older rather than younger patients and emphasize aspirin and early treatment of high blood pressure. The study, which focused on Australia, Canada, New Zealand, the United Kingdom, and the United States, was conducted by former Commonwealth Fund Harkness Fellow Tom Marshall, Ph.D., and published in the Journal of Evaluation in Clinical Practice.

Long-Term Care Financing: A Shared Responsibility
Financing the nation's long-term care needs should be a responsibility shared equally by government and individuals, agreed a majority of experts responding to the latest Commonwealth Fund Health Care Opinion Leaders survey. A wide majority of the 246 respondents to the online survey also favors adding a long-term care benefit to Medicare, financed by a premium, to address the growing cost of such services. The survey, which represents a range of health care sectors and diverse perspectives, is the sixth in a series conducted by Harris Interactive for the Fund.

More Public Data Needed to Spur Improvements in Long-Term Care
For some time, the long-term care sector has been using data to measure and improve the quality of care, and there have been some positive developments. But in a Fund-supported analysis in Milbank Quarterly, Vincent Mor, Ph.D., of Brown University School of Medicine argues that measurement of long-term health care quality needs to employ objective standards to become more reliable. After examining the work of long-term care advocates, consumers, practitioners, insurers, and regulators, Mor concludes that further research is needed to explore how consumers use quality information and how measurement efforts could improve care outcomes.

Sustaining an Innovation in Elder Care
Once an organization adopts new health innovations, what determines whether improvements are sustained over the long term? Elizabeth H. Bradley, Ph.D., of the Yale School of Medicine and her colleagues sought to find out by examining the experiences of 13 hospitals that adopted the Hospital Elder Life Program (HELP), a cost-effective method for keeping older patients mentally and physically active. The Fund-supported researchers, who reported their findings in the Journal of the American Geriatrics Society, determined that leaders in hospitals that sustained HELP not only played important clinical roles but acted as strong supporters with senior administration. Other success factors were the ability to adapt the program to local needs and ingenuity in securing adequate funding.

States Focusing on Kids' 'Healthy Mental Development'
A new report from the National Academy of State Health Policy examines how states are promoting the healthy mental development of children age 3 and under. Based on a survey of Medicaid, maternal and child health, and children's mental health agencies across the nation, State Approaches to Promoting Young Children's Healthy Mental Development looks at critical issues confronting states, from funding concerns to the availability of qualified mental health providers. The authors also highlight common approaches to addressing these issues, as well as promising new initiatives under way to improve service delivery and financing.

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