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Recent Commonwealth Fund reports and Fund-supported studies in the professional literature.

After Adoption: Sustaining the Innovation—A Case Study of Disseminating the Hospital Elder Life Program. Elizabeth H. Bradley, Ph.D., Tashonna R. Webster, M.P.H., Dorothy Baker, Ph.D., R.N.C.S., Mark Schlesinger, Ph.D., and Sharon K. Inouye, M.D., M.P.H. Journal of the American Geriatrics Society, September 2005. The Hospital Elder Life Program has been proven successful in helping older hospitalized patients stay mentally and physically active. This Fund-supported study shows how hospitals that have adopted the program are sustaining it for the long term.

Improving the Quality of Long-Term Care with Better Information. Vincent Mor, Ph.D. Milbank Quarterly, September 2005. While great strides have been made in the collection and public reporting of data on long-term care quality, the authors question whether and how this information actually helps consumers choose providers.

Taking the Pulse of Health Care Systems: Experiences of Patients with Health Problems in Six Countries. Cathy Schoen, M.S., Robin Osborn, M.B.A., Phuong Trang Huynh, Ph.D., Michelle M. Doty, Ph.D., Kinga Zapert, Ph.D., Jordon Peugh, M.A., and Karen Davis, Ph.D. Health Affairs Web Exclusive, November 3, 2005. A Fund-supported international survey finds that one-third of U.S. patients with health problems reported experiencing medical mistakes, medication errors, or inaccurate or delayed lab results—the highest rate of any of the six nations surveyed.

The Commonwealth Fund 2005 International Health Policy Survey of Sicker Adults in Six Countries. Cathy Schoen, M.S., Robin Osborn, M.B.A., Phuong Trang Huynh, Ph.D., Michelle M. Doty, Ph.D., and Jennifer A. Fenley. November 2005. Available in Powerpoint and PDF formats, this chartpack contains nearly 40 slides detailing the health system experiences of adults with health problems.

Quality Matters: Putting Engineering to Work in Health Care. October 20, 2005. This e-newsletter focuses on happenings in the field of quality improvement. In the October issue, the editors explore how engineering principles are being put to work to improve the safety, quality, and efficiency of care.

Limited Take-Up of Health Coverage Tax Credits: A Challenge to Future Tax Credit Design. Stan Dorn, J.D., Janet Varon, J.D., and Fouad Pervez, M.P.H. October 2005. The latest enrollment figures for Trade Act tax credits again show disappointingly low take-up rates, with high insurance premium costs, a complex application process, and inadequate outreach the prime causes.

A 2020 Vision of Patient-Centered Primary Care. Karen Davis, Ph.D., Stephen C. Schoenbaum, M.D., and Anne-Marie Audet, M.D. Journal of General Internal Medicine, October 2005. Despite significant strides, "patient-centered" care is not yet the norm throughout the U.S. health care system. An article by Fund experts shows how primary care in the U.S. can be taken to the next level.

A Need to Transform the U.S. Health Care System: Improving Access, Quality, and Efficiency. Anne Gauthier, M.S., and Michelle Serber. October 2005. The fragmented U.S. health system is fraught with waste and inefficiency, as documented by this chartbook from the Fund's Commission on a High Performance Health System.

Early Experience with Pay-for-Performance: From Concept to Practice. Meredith B. Rosenthal, Ph.D., Richard G. Frank, Ph.D., Zhonghe Li, M.A., and Arnold M. Epstein, M.D., M.A. Journal of the American Medical Association, October 12, 2005. A study of pay-for-performance in action at one of the nation's largest health plans found that for one of three clinical quality measures studied, a physician network that was offered bonus payments outperformed another network that was not.

Medicare Extra: A Comprehensive Benefit Option for Medicare Beneficiaries. Karen Davis, Ph.D., Marilyn Moon, Ph.D., Barbara S. Cooper, and Cathy Schoen, M.S. Health Affairs Web Exclusive, October 4, 2005. A group of health policy analysts propose a new comprehensive benefit option for the traditional fee-for-service Medicare program, featuring less confusion and lower cost than private drug plan and Medigap offerings.

Unmet Long-Term Care Needs: An Analysis of Medicare–Medicaid Dual Eligibles. Harriet L. Komisar, Ph.D., Judith Feder, Ph.D., and Judith Kasper, Ph.D. Inquiry, Summer 2005. In a survey of elderly "dual eligibles" living in the community, more than half of those who need assistance with activities of daily living said they do not receive enough help.

The Value of Electronic Health Records in Solo or Small Group Practices. Robert H. Miller, Ph.D., Christopher West, Tiffany Martin Brown, M.A., Ida Sim, M.D., Ph.D., and Chris Ganchoff, M.A. Health Affairs, September/October 2005. The authors conducted 14 case studies of solo or small primary care practices that had used electronic health records (EHRs) for one to three years, and determined that small physician practices recouped the cost of investing in EHRs in two-and-a-half years.

Entrances and Exits: Health Insurance Churning, 1998–2000. Kathryn Klein, M.P.H., Sherry Glied, Ph.D., and Danielle Ferry, M.S. September 2005. This issue brief reveals that 22 percent of the U.S. population experienced at least one spell without any health coverage over a two-year period, in addition to the 9 percent who were uninsured for the full two years. Those with private, nongroup insurance were among the most likely to have unstable coverage.

"Choice" in Health Care: What Do People Really Want? Jeanne M. Lambrew, Ph.D. September 2005. People value a choice of health care providers over a choice of health plans, according to this analysis of Fund survey data. Dissatisfaction among adults who have no choice of provider was more than twice as high compared to adults with no choice of plan.

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