Mary Ellen Schneider

Adoption of health information technology varies significantly among physicians in different specialties, according to a new study from the Center for Studying Health System Change.

While only 12% of physicians overall have adopted comprehensive electronic medical records, physician uptake of specific health IT functions, such as obtaining guidelines or writing prescriptions, varies depending on specialty. For example, 74% of emergency physicians have health IT systems that can access patient notes, compared with just 36% of psychiatrists.

The findings are based on the Health System Change (HSC) 2004–2005 Community Tracking Study Physician Survey, a nationally representative telephone poll that included responses from a total of 6,628 physicians.

As part of the survey, physicians were asked about practice-based availability of information technology across five clinical areas—obtaining information about treatment alternatives or recommended guidelines; retrieving patient notes or problem lists; writing prescriptions; exchanging clinical data and images with other physicians; and exchanging clinical data and images with hospitals. Because physicians were asked about the availability of these health IT functions, not whether they actually used the technology, they were considered to have an electronic medical record if they answered that they had access to all five functions.

Surgeons trailed medical specialists in obtaining guidelines, accessing patient notes, writing prescriptions, and exchanging information with other physicians. Primary care physicians were less likely than specialists to access patient notes and exchange data with other physicians.

There were also variations across specialties and subspecialties. For example, within primary care, internists were more likely than family physicians or pediatricians to have access to patient notes. Among subspecialists, oncologists were more likely than other specialists to obtain guidelines, exchange information with other physicians, and exchange information with hospitals.

One factor in the variation among specialties may be that certain clinical activities are more relevant for certain specialties. “Surgeons may have less need for IT to write prescriptions since they typically prescribe a narrow range of on-formulary medications on a short-term basis, in contrast to medical specialists and PCPs who treat chronically ill patients taking multiple medications,” Catherine Corey, an HSC health research analyst and one of the study authors, said in a statement.

The full report is available online at www.hschange.com/CONTENT/945/

ELSEVIER GLOBAL MEDICAL NEWS

Adoption of health information technology varies significantly among physicians in different specialties, according to a new study from the Center for Studying Health System Change.

While only 12% of physicians overall have adopted comprehensive electronic medical records, physician uptake of specific health IT functions, such as obtaining guidelines or writing prescriptions, varies depending on specialty. For example, 74% of emergency physicians have health IT systems that can access patient notes, compared with just 36% of psychiatrists.

The findings are based on the Health System Change (HSC) 2004–2005 Community Tracking Study Physician Survey, a nationally representative telephone poll that included responses from a total of 6,628 physicians.

As part of the survey, physicians were asked about practice-based availability of information technology across five clinical areas—obtaining information about treatment alternatives or recommended guidelines; retrieving patient notes or problem lists; writing prescriptions; exchanging clinical data and images with other physicians; and exchanging clinical data and images with hospitals. Because physicians were asked about the availability of these health IT functions, not whether they actually used the technology, they were considered to have an electronic medical record if they answered that they had access to all five functions.

Surgeons trailed medical specialists in obtaining guidelines, accessing patient notes, writing prescriptions, and exchanging information with other physicians. Primary care physicians were less likely than specialists to access patient notes and exchange data with other physicians.

There were also variations across specialties and subspecialties. For example, within primary care, internists were more likely than family physicians or pediatricians to have access to patient notes. Among subspecialists, oncologists were more likely than other specialists to obtain guidelines, exchange information with other physicians, and exchange information with hospitals.

One factor in the variation among specialties may be that certain clinical activities are more relevant for certain specialties. “Surgeons may have less need for IT to write prescriptions since they typically prescribe a narrow range of on-formulary medications on a short-term basis, in contrast to medical specialists and PCPs who treat chronically ill patients taking multiple medications,” Catherine Corey, an HSC health research analyst and one of the study authors, said in a statement.

The full report is available online at www.hschange.com/CONTENT/945/

ELSEVIER GLOBAL MEDICAL NEWS

Adoption of health information technology varies significantly among physicians in different specialties, according to a new study from the Center for Studying Health System Change.

While only 12% of physicians overall have adopted comprehensive electronic medical records, physician uptake of specific health IT functions, such as obtaining guidelines or writing prescriptions, varies depending on specialty. For example, 74% of emergency physicians have health IT systems that can access patient notes, compared with just 36% of psychiatrists.

The findings are based on the Health System Change (HSC) 2004–2005 Community Tracking Study Physician Survey, a nationally representative telephone poll that included responses from a total of 6,628 physicians.

As part of the survey, physicians were asked about practice-based availability of information technology across five clinical areas—obtaining information about treatment alternatives or recommended guidelines; retrieving patient notes or problem lists; writing prescriptions; exchanging clinical data and images with other physicians; and exchanging clinical data and images with hospitals. Because physicians were asked about the availability of these health IT functions, not whether they actually used the technology, they were considered to have an electronic medical record if they answered that they had access to all five functions.

Surgeons trailed medical specialists in obtaining guidelines, accessing patient notes, writing prescriptions, and exchanging information with other physicians. Primary care physicians were less likely than specialists to access patient notes and exchange data with other physicians.

There were also variations across specialties and subspecialties. For example, within primary care, internists were more likely than family physicians or pediatricians to have access to patient notes. Among subspecialists, oncologists were more likely than other specialists to obtain guidelines, exchange information with other physicians, and exchange information with hospitals.

One factor in the variation among specialties may be that certain clinical activities are more relevant for certain specialties. “Surgeons may have less need for IT to write prescriptions since they typically prescribe a narrow range of on-formulary medications on a short-term basis, in contrast to medical specialists and PCPs who treat chronically ill patients taking multiple medications,” Catherine Corey, an HSC health research analyst and one of the study authors, said in a statement.

The full report is available online at www.hschange.com/CONTENT/945/

ELSEVIER GLOBAL MEDICAL NEWS

Private payers are watching with interest to see how Medicare implements its new policy of withholding payment for certain hospital-acquired conditions and infections.

But Minnesota is already leading the way in this area. In 2003, the state began requiring hospitals to report on 27 so-called “never events” identified at that time by the National Quality Forum (NQF). The NQF list of such adverse events, defined as mistakes that should never occur in the hospital, includes wrong-site surgeries, objects left during surgery, and serious medication errors.

Under the Minnesota reporting law, hospitals must report these never events, investigate the underlying cause, and take corrective action.

In September, Gov. Tim Pawlenty (R) announced the next step. Hospitals in the state have agreed not to bill insurance companies or patients for any of the 27 events identified by the NQF.

“It seems obvious to us, but Minnesota is the first state in the nation to agree that patients, employers, and insurers shouldn't pay for care made necessary by an adverse health event,” Gov. Pawlenty said in a statement. “We hope more states will follow our lead.”

The plan, which was created by the Minnesota Hospital Association and the Minnesota Council of Health Plans, is similar to a program launched in 2005 by HealthPartners Inc., a Minnesota-based health care insurer.

Building on the earlier quality-reporting efforts within the state, HealthPartners not only stopped paying hospitals for charges associated with never events, it also prohibited hospitals from billing the plan's members.

The program has become a national model, according to Babette Apland, senior vice president for health and care management at HealthPartners. Officials from the plan have consulted with the Leapfrog Group and the Medicare Payment Advisory Commission.

Although there was some controversy around the HealthPartners policy when it was first implemented, hospitals quickly got on board, Ms. Apland said.

Because never events are rare, the savings to the health plan for withholding payment has been negligible, Ms. Apland said. Instead, the program's aim was to provide hospitals with an incentive to systematically prevent these events.

Private payers are watching with interest to see how Medicare implements its new policy of withholding payment for certain hospital-acquired conditions and infections.

But Minnesota is already leading the way in this area. In 2003, the state began requiring hospitals to report on 27 so-called “never events” identified at that time by the National Quality Forum (NQF). The NQF list of such adverse events, defined as mistakes that should never occur in the hospital, includes wrong-site surgeries, objects left during surgery, and serious medication errors.

Under the Minnesota reporting law, hospitals must report these never events, investigate the underlying cause, and take corrective action.

In September, Gov. Tim Pawlenty (R) announced the next step. Hospitals in the state have agreed not to bill insurance companies or patients for any of the 27 events identified by the NQF.

“It seems obvious to us, but Minnesota is the first state in the nation to agree that patients, employers, and insurers shouldn't pay for care made necessary by an adverse health event,” Gov. Pawlenty said in a statement. “We hope more states will follow our lead.”

The plan, which was created by the Minnesota Hospital Association and the Minnesota Council of Health Plans, is similar to a program launched in 2005 by HealthPartners Inc., a Minnesota-based health care insurer.

Building on the earlier quality-reporting efforts within the state, HealthPartners not only stopped paying hospitals for charges associated with never events, it also prohibited hospitals from billing the plan's members.

The program has become a national model, according to Babette Apland, senior vice president for health and care management at HealthPartners. Officials from the plan have consulted with the Leapfrog Group and the Medicare Payment Advisory Commission.

Although there was some controversy around the HealthPartners policy when it was first implemented, hospitals quickly got on board, Ms. Apland said.

Because never events are rare, the savings to the health plan for withholding payment has been negligible, Ms. Apland said. Instead, the program's aim was to provide hospitals with an incentive to systematically prevent these events.

Private payers are watching with interest to see how Medicare implements its new policy of withholding payment for certain hospital-acquired conditions and infections.

But Minnesota is already leading the way in this area. In 2003, the state began requiring hospitals to report on 27 so-called “never events” identified at that time by the National Quality Forum (NQF). The NQF list of such adverse events, defined as mistakes that should never occur in the hospital, includes wrong-site surgeries, objects left during surgery, and serious medication errors.

Under the Minnesota reporting law, hospitals must report these never events, investigate the underlying cause, and take corrective action.

In September, Gov. Tim Pawlenty (R) announced the next step. Hospitals in the state have agreed not to bill insurance companies or patients for any of the 27 events identified by the NQF.

“It seems obvious to us, but Minnesota is the first state in the nation to agree that patients, employers, and insurers shouldn't pay for care made necessary by an adverse health event,” Gov. Pawlenty said in a statement. “We hope more states will follow our lead.”

The plan, which was created by the Minnesota Hospital Association and the Minnesota Council of Health Plans, is similar to a program launched in 2005 by HealthPartners Inc., a Minnesota-based health care insurer.

Building on the earlier quality-reporting efforts within the state, HealthPartners not only stopped paying hospitals for charges associated with never events, it also prohibited hospitals from billing the plan's members.

The program has become a national model, according to Babette Apland, senior vice president for health and care management at HealthPartners. Officials from the plan have consulted with the Leapfrog Group and the Medicare Payment Advisory Commission.

Although there was some controversy around the HealthPartners policy when it was first implemented, hospitals quickly got on board, Ms. Apland said.

Because never events are rare, the savings to the health plan for withholding payment has been negligible, Ms. Apland said. Instead, the program's aim was to provide hospitals with an incentive to systematically prevent these events.

Cost containment strategies, such as tiered drug plans, reduce overall prescription drug utilization and increase the use of generics, according to an analysis of prescription drug use by Medicare-eligible retirees.

But even with decreased utilization, individuals enrolled in three-tiered drug plans, which charge higher copayments for certain medications, spent more money out of pocket than did individuals enrolled in single-tiered plans.

The study, conducted by researchers at Mathematica Policy Research Inc. and RTI International, included 352,760 Medicare beneficiaries with employer-sponsored drug coverage and dependent spouses aged 65 or older.

The researchers analyzed five employer-sponsored drug plans: two with a single copayment tier, and three with a three-tiered structure.

The study is further confirmation that the retiree population is sensitive to price, Boyd H. Gilman, Ph.D., one of the study authors and a senior researcher at the Cambridge, Mass., office of Mathematica, said in an interview.

“They do respond to price, but we don't know what that means in terms of health outcomes,” he said.

On average, individuals in single-tiered plans filled 46 prescriptions a year, compared with 38 prescriptions among those enrolled in three-tiered plans. But enrollees in singled-tiered plans used fewer generics, the researchers found.

Nearly 39% of the drugs purchased under single-tier plans were generics, compared with nearly 44% in three-tiered plans. Both findings were statistically significant. The average annual expenditures by the drug plan per enrollee were higher in single-tiered plans. In contrast, enrollee out-of-pocket costs were higher among those enrolled in three-tiered drug plans, despite their lower drug utilization.

Drug plans spent about $1,943 per individual in single-tiered plans, versus $1,354 in three-tiered plans.

Individuals enrolled in single-tier plans spent about $245 a year, compared with $469 spent by individuals enrolled in multitiered plans. These results were also statistically significant.

When they examined trends among individuals who filled prescriptions for chronic conditions, the researchers found that cost containment strategies had less of an effect on prescription drug use. Total expenditures and the number of prescriptions filled were still lower among beneficiaries enrolled in three-tiered plans, but to a lesser extent than when these individuals filled prescriptions for episodic care.

The findings were published online on Sept. 11 in the journal Health Services Research (Health Serv. Res. 2007 Sept. 11 [Epub doi:10.1111/j.1475–6773. 2007.00774.x]). The study was funded by an internal grant from RTI International.

Cost containment strategies, such as tiered drug plans, reduce overall prescription drug utilization and increase the use of generics, according to an analysis of prescription drug use by Medicare-eligible retirees.

But even with decreased utilization, individuals enrolled in three-tiered drug plans, which charge higher copayments for certain medications, spent more money out of pocket than did individuals enrolled in single-tiered plans.

The study, conducted by researchers at Mathematica Policy Research Inc. and RTI International, included 352,760 Medicare beneficiaries with employer-sponsored drug coverage and dependent spouses aged 65 or older.

The researchers analyzed five employer-sponsored drug plans: two with a single copayment tier, and three with a three-tiered structure.

The study is further confirmation that the retiree population is sensitive to price, Boyd H. Gilman, Ph.D., one of the study authors and a senior researcher at the Cambridge, Mass., office of Mathematica, said in an interview.

“They do respond to price, but we don't know what that means in terms of health outcomes,” he said.

On average, individuals in single-tiered plans filled 46 prescriptions a year, compared with 38 prescriptions among those enrolled in three-tiered plans. But enrollees in singled-tiered plans used fewer generics, the researchers found.

Nearly 39% of the drugs purchased under single-tier plans were generics, compared with nearly 44% in three-tiered plans. Both findings were statistically significant. The average annual expenditures by the drug plan per enrollee were higher in single-tiered plans. In contrast, enrollee out-of-pocket costs were higher among those enrolled in three-tiered drug plans, despite their lower drug utilization.

Drug plans spent about $1,943 per individual in single-tiered plans, versus $1,354 in three-tiered plans.

Individuals enrolled in single-tier plans spent about $245 a year, compared with $469 spent by individuals enrolled in multitiered plans. These results were also statistically significant.

When they examined trends among individuals who filled prescriptions for chronic conditions, the researchers found that cost containment strategies had less of an effect on prescription drug use. Total expenditures and the number of prescriptions filled were still lower among beneficiaries enrolled in three-tiered plans, but to a lesser extent than when these individuals filled prescriptions for episodic care.

The findings were published online on Sept. 11 in the journal Health Services Research (Health Serv. Res. 2007 Sept. 11 [Epub doi:10.1111/j.1475–6773. 2007.00774.x]). The study was funded by an internal grant from RTI International.

Cost containment strategies, such as tiered drug plans, reduce overall prescription drug utilization and increase the use of generics, according to an analysis of prescription drug use by Medicare-eligible retirees.

But even with decreased utilization, individuals enrolled in three-tiered drug plans, which charge higher copayments for certain medications, spent more money out of pocket than did individuals enrolled in single-tiered plans.

The study, conducted by researchers at Mathematica Policy Research Inc. and RTI International, included 352,760 Medicare beneficiaries with employer-sponsored drug coverage and dependent spouses aged 65 or older.

The researchers analyzed five employer-sponsored drug plans: two with a single copayment tier, and three with a three-tiered structure.

The study is further confirmation that the retiree population is sensitive to price, Boyd H. Gilman, Ph.D., one of the study authors and a senior researcher at the Cambridge, Mass., office of Mathematica, said in an interview.

“They do respond to price, but we don't know what that means in terms of health outcomes,” he said.

On average, individuals in single-tiered plans filled 46 prescriptions a year, compared with 38 prescriptions among those enrolled in three-tiered plans. But enrollees in singled-tiered plans used fewer generics, the researchers found.

Nearly 39% of the drugs purchased under single-tier plans were generics, compared with nearly 44% in three-tiered plans. Both findings were statistically significant. The average annual expenditures by the drug plan per enrollee were higher in single-tiered plans. In contrast, enrollee out-of-pocket costs were higher among those enrolled in three-tiered drug plans, despite their lower drug utilization.

Drug plans spent about $1,943 per individual in single-tiered plans, versus $1,354 in three-tiered plans.

Individuals enrolled in single-tier plans spent about $245 a year, compared with $469 spent by individuals enrolled in multitiered plans. These results were also statistically significant.

When they examined trends among individuals who filled prescriptions for chronic conditions, the researchers found that cost containment strategies had less of an effect on prescription drug use. Total expenditures and the number of prescriptions filled were still lower among beneficiaries enrolled in three-tiered plans, but to a lesser extent than when these individuals filled prescriptions for episodic care.

The findings were published online on Sept. 11 in the journal Health Services Research (Health Serv. Res. 2007 Sept. 11 [Epub doi:10.1111/j.1475–6773. 2007.00774.x]). The study was funded by an internal grant from RTI International.

The number of Americans without health insurance reached 47 million last year, up from 44.8 million in 2005, according to new data released by the U.S. Census Bureau.

The percentage of individuals without health insurance also rose from 15.3% in 2005 to 15.8% in 2006.

This rise includes an increase in the number of uninsured children. The percentage and number of children under age 18 without health insurance increased from 8 million (10.9%) in 2005 to 8.7 million (11.7%) in 2006. Much of the increase in the uninsured rate for children can be attributed to a decline in private coverage, David Johnson, chief of the division of housing and household economic statistics at the Census Bureau, said during a news conference.

Overall, the percentage of individuals covered by any type of private insurance plan dropped from 68.5% in 2005 to 67.9% in 2006. And among children, the percentage with private coverage fell from 65.8% in 2005 to 64.6% in 2006, Mr. Johnson said.

At the same time, coverage by government insurance was also down from 27.3% in 2005 to 27% in 2006. The data are compiled from the 2007 Current Population Survey Annual Social and Economic Supplement.

The increase in the number of uninsured individuals between 2005 and 2006 is “pretty shocking,” said Karen Davis, Ph.D., president of The Commonwealth Fund, especially in a year when states have been under less financial pressure and many have been trying to expand coverage.

The deterioration of dependent coverage among private plans is particularly disturbing and points to the importance of reauthorizing the State Children's Health Insurance Program (SCHIP) with adequate funding, she said.

The number and percentage of uninsured children had been falling between 1998 and 2004 but that progress began to reverse in 2005, said Robert Greenstein, executive director of the Center on Budget and Policy Priorities. These latest data from the Census Bureau show that the country is “losing significant ground” in insuring children, he said, and he called on President Bush to rethink his position on funding for SCHIP.

The number of Americans without health insurance reached 47 million last year, up from 44.8 million in 2005, according to new data released by the U.S. Census Bureau.

The percentage of individuals without health insurance also rose from 15.3% in 2005 to 15.8% in 2006.

This rise includes an increase in the number of uninsured children. The percentage and number of children under age 18 without health insurance increased from 8 million (10.9%) in 2005 to 8.7 million (11.7%) in 2006. Much of the increase in the uninsured rate for children can be attributed to a decline in private coverage, David Johnson, chief of the division of housing and household economic statistics at the Census Bureau, said during a news conference.

Overall, the percentage of individuals covered by any type of private insurance plan dropped from 68.5% in 2005 to 67.9% in 2006. And among children, the percentage with private coverage fell from 65.8% in 2005 to 64.6% in 2006, Mr. Johnson said.

At the same time, coverage by government insurance was also down from 27.3% in 2005 to 27% in 2006. The data are compiled from the 2007 Current Population Survey Annual Social and Economic Supplement.

The increase in the number of uninsured individuals between 2005 and 2006 is “pretty shocking,” said Karen Davis, Ph.D., president of The Commonwealth Fund, especially in a year when states have been under less financial pressure and many have been trying to expand coverage.

The deterioration of dependent coverage among private plans is particularly disturbing and points to the importance of reauthorizing the State Children's Health Insurance Program (SCHIP) with adequate funding, she said.

The number and percentage of uninsured children had been falling between 1998 and 2004 but that progress began to reverse in 2005, said Robert Greenstein, executive director of the Center on Budget and Policy Priorities. These latest data from the Census Bureau show that the country is “losing significant ground” in insuring children, he said, and he called on President Bush to rethink his position on funding for SCHIP.

The number of Americans without health insurance reached 47 million last year, up from 44.8 million in 2005, according to new data released by the U.S. Census Bureau.

The percentage of individuals without health insurance also rose from 15.3% in 2005 to 15.8% in 2006.

This rise includes an increase in the number of uninsured children. The percentage and number of children under age 18 without health insurance increased from 8 million (10.9%) in 2005 to 8.7 million (11.7%) in 2006. Much of the increase in the uninsured rate for children can be attributed to a decline in private coverage, David Johnson, chief of the division of housing and household economic statistics at the Census Bureau, said during a news conference.

Overall, the percentage of individuals covered by any type of private insurance plan dropped from 68.5% in 2005 to 67.9% in 2006. And among children, the percentage with private coverage fell from 65.8% in 2005 to 64.6% in 2006, Mr. Johnson said.

At the same time, coverage by government insurance was also down from 27.3% in 2005 to 27% in 2006. The data are compiled from the 2007 Current Population Survey Annual Social and Economic Supplement.

The increase in the number of uninsured individuals between 2005 and 2006 is “pretty shocking,” said Karen Davis, Ph.D., president of The Commonwealth Fund, especially in a year when states have been under less financial pressure and many have been trying to expand coverage.

The deterioration of dependent coverage among private plans is particularly disturbing and points to the importance of reauthorizing the State Children's Health Insurance Program (SCHIP) with adequate funding, she said.

The number and percentage of uninsured children had been falling between 1998 and 2004 but that progress began to reverse in 2005, said Robert Greenstein, executive director of the Center on Budget and Policy Priorities. These latest data from the Census Bureau show that the country is “losing significant ground” in insuring children, he said, and he called on President Bush to rethink his position on funding for SCHIP.

ORLANDO — Patient wishes for organ donation were overridden by family members in about 20% of cases, creating “missed opportunities” for organ procurement, according to research conducted at a level I trauma center in Charlotte, N.C.

Dr. A. Britton Christmas and colleagues at the F.H. Sammy Ross Jr. Center at the Carolinas Medical Center reviewed 3 months of organ donation referrals at their center. They estimated that about 17 potential transplant recipients did not receive organs because a patient's previous donation intentions were overridden by family members. The research was presented in a poster at the annual congress of the Society of Critical Care Medicine.

The researchers examined charts to determine the appropriateness for donation, familial consent or denial for donation, and the number of organs transplanted from each donor. They compared their records with data from the state department of motor vehicles (DMV) related to organ donation designations.

The researchers analyzed information on 84 individuals who had information on file with the DMV and whose families had been approached by hospital staff for organ donation over the 3-month period. According to DMV records, 25 individuals were listed as organ donors, and 59 had not designated organ donation.

For the 25 individuals who had designated themselves as organ donors, 20 consents for donation were obtained from family members. Of the remaining 59 individuals, 22 consents for organ donation were obtained.

Although the organ recovery rate was higher among those who had already specified a desire to be donors (80% vs. 37%), some families chose to override a previous designation of organ donation. With an average of 3.4 organs transplanted from each eligible donor, the researchers estimated that the five individuals whose consent was withdrawn by the families resulted in 17 potential organ recipients who would not receive organs.

ORLANDO — Patient wishes for organ donation were overridden by family members in about 20% of cases, creating “missed opportunities” for organ procurement, according to research conducted at a level I trauma center in Charlotte, N.C.

Dr. A. Britton Christmas and colleagues at the F.H. Sammy Ross Jr. Center at the Carolinas Medical Center reviewed 3 months of organ donation referrals at their center. They estimated that about 17 potential transplant recipients did not receive organs because a patient's previous donation intentions were overridden by family members. The research was presented in a poster at the annual congress of the Society of Critical Care Medicine.

The researchers examined charts to determine the appropriateness for donation, familial consent or denial for donation, and the number of organs transplanted from each donor. They compared their records with data from the state department of motor vehicles (DMV) related to organ donation designations.

The researchers analyzed information on 84 individuals who had information on file with the DMV and whose families had been approached by hospital staff for organ donation over the 3-month period. According to DMV records, 25 individuals were listed as organ donors, and 59 had not designated organ donation.

For the 25 individuals who had designated themselves as organ donors, 20 consents for donation were obtained from family members. Of the remaining 59 individuals, 22 consents for organ donation were obtained.

Although the organ recovery rate was higher among those who had already specified a desire to be donors (80% vs. 37%), some families chose to override a previous designation of organ donation. With an average of 3.4 organs transplanted from each eligible donor, the researchers estimated that the five individuals whose consent was withdrawn by the families resulted in 17 potential organ recipients who would not receive organs.

ORLANDO — Patient wishes for organ donation were overridden by family members in about 20% of cases, creating “missed opportunities” for organ procurement, according to research conducted at a level I trauma center in Charlotte, N.C.

Dr. A. Britton Christmas and colleagues at the F.H. Sammy Ross Jr. Center at the Carolinas Medical Center reviewed 3 months of organ donation referrals at their center. They estimated that about 17 potential transplant recipients did not receive organs because a patient's previous donation intentions were overridden by family members. The research was presented in a poster at the annual congress of the Society of Critical Care Medicine.

The researchers examined charts to determine the appropriateness for donation, familial consent or denial for donation, and the number of organs transplanted from each donor. They compared their records with data from the state department of motor vehicles (DMV) related to organ donation designations.

The researchers analyzed information on 84 individuals who had information on file with the DMV and whose families had been approached by hospital staff for organ donation over the 3-month period. According to DMV records, 25 individuals were listed as organ donors, and 59 had not designated organ donation.

For the 25 individuals who had designated themselves as organ donors, 20 consents for donation were obtained from family members. Of the remaining 59 individuals, 22 consents for organ donation were obtained.

Although the organ recovery rate was higher among those who had already specified a desire to be donors (80% vs. 37%), some families chose to override a previous designation of organ donation. With an average of 3.4 organs transplanted from each eligible donor, the researchers estimated that the five individuals whose consent was withdrawn by the families resulted in 17 potential organ recipients who would not receive organs.

Increasing the use of aspirin, colorectal cancer screening, influenza immunizations, and a few other simple preventive measures would save more than 100,000 lives each year in the United States, according to a new study.

The biggest lifesaver identified in the study is aspirin. Researchers found that an additional 45,000 lives could be saved each year if the portion of adults who take aspirin daily to prevent heart disease was increased to 90%. As of 2005, about 40% of men aged 40 and older and women aged 50 and older reported daily aspirin use.

Counseling on smoking cessation would also have a significant impact. An additional 42,000 lives could be saved each year if 90% of smokers were advised to quit by their physician or health care provider and offered medication or other assistance. In addition, immunizing 90% of adults aged 50 and older against influenza each year would save about 12,000 lives.

Screening and early detection of disease is also a potential lifesaver for thousands of Americans, the study found. Nearly 4,000 lives could be saved annually if 90% of women aged 40 and older were screened for breast cancer in the past 2 years. And 14,000 lives could be saved annually if 90% of adults aged 50 and older were up to date with recommended screening for colorectal cancer.

The study was conducted by researchers from the Partnership for Prevention, HealthPartners Research Foundation, and the National Commission on Prevention Priorities. The effort was funded by the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the WellPoint Foundation.

Although these actions seem simple, the United States is falling short on most of these benchmarks. Among the 12 preventive services analyzed in the report, 7 are received by about 50% or less of the individuals who need them.

But the biggest shortfalls in preventive care occur among racial and ethnic minorities. For example, Hispanics have a lower level of utilization for 10 preventive services analyzed in the report, compared with both non-Hispanic whites and African Americans. Asian Americans are also getting fewer preventive services. This group had the lowest rates of aspirin use, as well as of screening for breast, cervical, and colorectal cancer.

The full report is available online at www.prevent.org

Increasing the use of aspirin, colorectal cancer screening, influenza immunizations, and a few other simple preventive measures would save more than 100,000 lives each year in the United States, according to a new study.

The biggest lifesaver identified in the study is aspirin. Researchers found that an additional 45,000 lives could be saved each year if the portion of adults who take aspirin daily to prevent heart disease was increased to 90%. As of 2005, about 40% of men aged 40 and older and women aged 50 and older reported daily aspirin use.

Counseling on smoking cessation would also have a significant impact. An additional 42,000 lives could be saved each year if 90% of smokers were advised to quit by their physician or health care provider and offered medication or other assistance. In addition, immunizing 90% of adults aged 50 and older against influenza each year would save about 12,000 lives.

Screening and early detection of disease is also a potential lifesaver for thousands of Americans, the study found. Nearly 4,000 lives could be saved annually if 90% of women aged 40 and older were screened for breast cancer in the past 2 years. And 14,000 lives could be saved annually if 90% of adults aged 50 and older were up to date with recommended screening for colorectal cancer.

The study was conducted by researchers from the Partnership for Prevention, HealthPartners Research Foundation, and the National Commission on Prevention Priorities. The effort was funded by the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the WellPoint Foundation.

Although these actions seem simple, the United States is falling short on most of these benchmarks. Among the 12 preventive services analyzed in the report, 7 are received by about 50% or less of the individuals who need them.

But the biggest shortfalls in preventive care occur among racial and ethnic minorities. For example, Hispanics have a lower level of utilization for 10 preventive services analyzed in the report, compared with both non-Hispanic whites and African Americans. Asian Americans are also getting fewer preventive services. This group had the lowest rates of aspirin use, as well as of screening for breast, cervical, and colorectal cancer.

The full report is available online at www.prevent.org

Increasing the use of aspirin, colorectal cancer screening, influenza immunizations, and a few other simple preventive measures would save more than 100,000 lives each year in the United States, according to a new study.

The biggest lifesaver identified in the study is aspirin. Researchers found that an additional 45,000 lives could be saved each year if the portion of adults who take aspirin daily to prevent heart disease was increased to 90%. As of 2005, about 40% of men aged 40 and older and women aged 50 and older reported daily aspirin use.

Counseling on smoking cessation would also have a significant impact. An additional 42,000 lives could be saved each year if 90% of smokers were advised to quit by their physician or health care provider and offered medication or other assistance. In addition, immunizing 90% of adults aged 50 and older against influenza each year would save about 12,000 lives.

Screening and early detection of disease is also a potential lifesaver for thousands of Americans, the study found. Nearly 4,000 lives could be saved annually if 90% of women aged 40 and older were screened for breast cancer in the past 2 years. And 14,000 lives could be saved annually if 90% of adults aged 50 and older were up to date with recommended screening for colorectal cancer.

The study was conducted by researchers from the Partnership for Prevention, HealthPartners Research Foundation, and the National Commission on Prevention Priorities. The effort was funded by the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the WellPoint Foundation.

Although these actions seem simple, the United States is falling short on most of these benchmarks. Among the 12 preventive services analyzed in the report, 7 are received by about 50% or less of the individuals who need them.

But the biggest shortfalls in preventive care occur among racial and ethnic minorities. For example, Hispanics have a lower level of utilization for 10 preventive services analyzed in the report, compared with both non-Hispanic whites and African Americans. Asian Americans are also getting fewer preventive services. This group had the lowest rates of aspirin use, as well as of screening for breast, cervical, and colorectal cancer.

The full report is available online at www.prevent.org

Adoption of health information technology varies significantly among physicians in different specialties, according to a new study from the Center for Studying Health System Change.

While only 12% of physicians overall have adopted comprehensive electronic medical records, physician uptake of specific health IT functions, such as obtaining guidelines or writing prescriptions, varies depending on specialty. For example, 74% of emergency physicians have health IT systems that can access patient notes, compared with just 36% of psychiatrists.

The findings are based on the Health System Change (HSC) 2004–2005 Community Tracking Study Physician Survey, a nationally representative telephone poll that included responses from 6,628 physicians.

As part of the survey, physicians were asked about practice-based availability of information technology across five clinical areas—obtaining information about treatment alternatives or recommended guidelines; retrieving patient notes or problem lists; writing prescriptions; exchanging clinical data and images with other physicians; and exchanging clinical data and images with hospitals.

Because physicians were asked about the availability of these health IT functions, not whether they actually used the technology, they were considered to have an electronic medical record if they answered that they had access to all five functions.

Surgeons trailed medical specialists in obtaining guidelines, accessing patient notes, writing prescriptions, and exchanging information with other physicians. Primary care physicians were less likely than specialists to access patient notes and exchange data with other physicians.

There were also variations across specialties and subspecialties. For example, within primary care, internists were more likely than family physicians or pediatricians to have access to patient notes. Among subspecialists, oncologists were more likely than other specialists to obtain guidelines, exchange information with other physicians, and exchange information with hospitals.

One factor in the variation among specialties may be that certain clinical activities are more relevant for certain specialties. "Surgeons may have less need for IT to write prescriptions since they typically prescribe a narrow range of on-formulary medications on a short-term basis, in contrast to medical specialists and PCPs who treat chronically ill patients taking multiple medications," Catherine Corey, an HSC health research analyst and one of the study authors, said in a statement.

Another reason that some specialties may lag behind in adoption of health IT is that existing electronic products for keeping medical records may not meet their needs. For example, previous surveys have noted that most pediatricians without EMRs say they couldn't find one with functionality specific to pediatrics.

The full report is available at www.hschange.com/CONTENT/945/

Adoption of health information technology varies significantly among physicians in different specialties, according to a new study from the Center for Studying Health System Change.

While only 12% of physicians overall have adopted comprehensive electronic medical records, physician uptake of specific health IT functions, such as obtaining guidelines or writing prescriptions, varies depending on specialty. For example, 74% of emergency physicians have health IT systems that can access patient notes, compared with just 36% of psychiatrists.

The findings are based on the Health System Change (HSC) 2004–2005 Community Tracking Study Physician Survey, a nationally representative telephone poll that included responses from 6,628 physicians.

As part of the survey, physicians were asked about practice-based availability of information technology across five clinical areas—obtaining information about treatment alternatives or recommended guidelines; retrieving patient notes or problem lists; writing prescriptions; exchanging clinical data and images with other physicians; and exchanging clinical data and images with hospitals.

Because physicians were asked about the availability of these health IT functions, not whether they actually used the technology, they were considered to have an electronic medical record if they answered that they had access to all five functions.

Surgeons trailed medical specialists in obtaining guidelines, accessing patient notes, writing prescriptions, and exchanging information with other physicians. Primary care physicians were less likely than specialists to access patient notes and exchange data with other physicians.

There were also variations across specialties and subspecialties. For example, within primary care, internists were more likely than family physicians or pediatricians to have access to patient notes. Among subspecialists, oncologists were more likely than other specialists to obtain guidelines, exchange information with other physicians, and exchange information with hospitals.

One factor in the variation among specialties may be that certain clinical activities are more relevant for certain specialties. "Surgeons may have less need for IT to write prescriptions since they typically prescribe a narrow range of on-formulary medications on a short-term basis, in contrast to medical specialists and PCPs who treat chronically ill patients taking multiple medications," Catherine Corey, an HSC health research analyst and one of the study authors, said in a statement.

Another reason that some specialties may lag behind in adoption of health IT is that existing electronic products for keeping medical records may not meet their needs. For example, previous surveys have noted that most pediatricians without EMRs say they couldn't find one with functionality specific to pediatrics.

The full report is available at www.hschange.com/CONTENT/945/

Adoption of health information technology varies significantly among physicians in different specialties, according to a new study from the Center for Studying Health System Change.

While only 12% of physicians overall have adopted comprehensive electronic medical records, physician uptake of specific health IT functions, such as obtaining guidelines or writing prescriptions, varies depending on specialty. For example, 74% of emergency physicians have health IT systems that can access patient notes, compared with just 36% of psychiatrists.

The findings are based on the Health System Change (HSC) 2004–2005 Community Tracking Study Physician Survey, a nationally representative telephone poll that included responses from 6,628 physicians.

As part of the survey, physicians were asked about practice-based availability of information technology across five clinical areas—obtaining information about treatment alternatives or recommended guidelines; retrieving patient notes or problem lists; writing prescriptions; exchanging clinical data and images with other physicians; and exchanging clinical data and images with hospitals.

Because physicians were asked about the availability of these health IT functions, not whether they actually used the technology, they were considered to have an electronic medical record if they answered that they had access to all five functions.

Surgeons trailed medical specialists in obtaining guidelines, accessing patient notes, writing prescriptions, and exchanging information with other physicians. Primary care physicians were less likely than specialists to access patient notes and exchange data with other physicians.

There were also variations across specialties and subspecialties. For example, within primary care, internists were more likely than family physicians or pediatricians to have access to patient notes. Among subspecialists, oncologists were more likely than other specialists to obtain guidelines, exchange information with other physicians, and exchange information with hospitals.

One factor in the variation among specialties may be that certain clinical activities are more relevant for certain specialties. "Surgeons may have less need for IT to write prescriptions since they typically prescribe a narrow range of on-formulary medications on a short-term basis, in contrast to medical specialists and PCPs who treat chronically ill patients taking multiple medications," Catherine Corey, an HSC health research analyst and one of the study authors, said in a statement.

Another reason that some specialties may lag behind in adoption of health IT is that existing electronic products for keeping medical records may not meet their needs. For example, previous surveys have noted that most pediatricians without EMRs say they couldn't find one with functionality specific to pediatrics.

The full report is available at www.hschange.com/CONTENT/945/

Influenza vaccination of children aged 6-23 months remains low, with only 21% of children in this age group being fully vaccinated against influenza during the 2005-2006 season, according to data from the Centers for Disease Control and Prevention.

The vaccination rate was similar for the 24-59 months group—recently added to groups officially recommended to receive influenza vaccine—in preliminary data from the 2006-2007 season.

Results from the 2006 National Immunization Survey found that 32% of children aged 6-23 months received at least one dose of the vaccine in the 2005-2006 season and 21% were fully vaccinated in accordance with recommendations from the CDC's Advisory Committee on Immunization Practices (ACIP).

The data reflect vaccination uptake in the second season since ACIP began recommending annual influenza vacation for children aged 6-23 months in 2004. The results are based on a sample of 13,546 children from across the country (MMWR 2007;56:959–63).

The 2005-2006 coverage levels were similar to those reported during the previous influenza season.

The national estimate for fully vaccinated children increased from 18% in 2004-2005 to 21% in 2005-2006. For children who received at least one dose of the vaccine, the rate fell from 33% in 2004-2005 to 32% in 2005-2006.

In addition to the national figures, CDC also analyzed state vaccination rates and found significant variation.

For example, the percentage of children who received at least one dose of influenza vaccine ranged from a low of 8% in Mississippi to a high of 53% in Connecticut. No state had more than 40% of children fully vaccinated, according to the study.

CDC researchers also took an early look at influenza vaccination rates for the 2006-2007 season using data from six immunization information system sentinel sites, located in Arizona, Michigan, Minnesota, Montana, Oregon, and the District of Columbia.

Researchers used the data from the sentinel sites to gauge compliance with a June 2006 ACIP recommendation, which called for routine influenza vaccination among children aged 6-59 months. The early data revealed that at all six sites less than 30% of children aged 6-23 months had been fully vaccinated and less than 20% of children aged 24-59 months were fully vaccinated against influenza during the 2006-2007 season (MMWR 2007; 56:963–5).

ELSEVIER GLOBAL MEDICAL NEWS

Influenza vaccination of children aged 6-23 months remains low, with only 21% of children in this age group being fully vaccinated against influenza during the 2005-2006 season, according to data from the Centers for Disease Control and Prevention.

The vaccination rate was similar for the 24-59 months group—recently added to groups officially recommended to receive influenza vaccine—in preliminary data from the 2006-2007 season.

Results from the 2006 National Immunization Survey found that 32% of children aged 6-23 months received at least one dose of the vaccine in the 2005-2006 season and 21% were fully vaccinated in accordance with recommendations from the CDC's Advisory Committee on Immunization Practices (ACIP).

The data reflect vaccination uptake in the second season since ACIP began recommending annual influenza vacation for children aged 6-23 months in 2004. The results are based on a sample of 13,546 children from across the country (MMWR 2007;56:959–63).

The 2005-2006 coverage levels were similar to those reported during the previous influenza season.

The national estimate for fully vaccinated children increased from 18% in 2004-2005 to 21% in 2005-2006. For children who received at least one dose of the vaccine, the rate fell from 33% in 2004-2005 to 32% in 2005-2006.

In addition to the national figures, CDC also analyzed state vaccination rates and found significant variation.

For example, the percentage of children who received at least one dose of influenza vaccine ranged from a low of 8% in Mississippi to a high of 53% in Connecticut. No state had more than 40% of children fully vaccinated, according to the study.

CDC researchers also took an early look at influenza vaccination rates for the 2006-2007 season using data from six immunization information system sentinel sites, located in Arizona, Michigan, Minnesota, Montana, Oregon, and the District of Columbia.

Researchers used the data from the sentinel sites to gauge compliance with a June 2006 ACIP recommendation, which called for routine influenza vaccination among children aged 6-59 months. The early data revealed that at all six sites less than 30% of children aged 6-23 months had been fully vaccinated and less than 20% of children aged 24-59 months were fully vaccinated against influenza during the 2006-2007 season (MMWR 2007; 56:963–5).

ELSEVIER GLOBAL MEDICAL NEWS

Influenza vaccination of children aged 6-23 months remains low, with only 21% of children in this age group being fully vaccinated against influenza during the 2005-2006 season, according to data from the Centers for Disease Control and Prevention.

The vaccination rate was similar for the 24-59 months group—recently added to groups officially recommended to receive influenza vaccine—in preliminary data from the 2006-2007 season.

Results from the 2006 National Immunization Survey found that 32% of children aged 6-23 months received at least one dose of the vaccine in the 2005-2006 season and 21% were fully vaccinated in accordance with recommendations from the CDC's Advisory Committee on Immunization Practices (ACIP).

The data reflect vaccination uptake in the second season since ACIP began recommending annual influenza vacation for children aged 6-23 months in 2004. The results are based on a sample of 13,546 children from across the country (MMWR 2007;56:959–63).

The 2005-2006 coverage levels were similar to those reported during the previous influenza season.

The national estimate for fully vaccinated children increased from 18% in 2004-2005 to 21% in 2005-2006. For children who received at least one dose of the vaccine, the rate fell from 33% in 2004-2005 to 32% in 2005-2006.

In addition to the national figures, CDC also analyzed state vaccination rates and found significant variation.

For example, the percentage of children who received at least one dose of influenza vaccine ranged from a low of 8% in Mississippi to a high of 53% in Connecticut. No state had more than 40% of children fully vaccinated, according to the study.

CDC researchers also took an early look at influenza vaccination rates for the 2006-2007 season using data from six immunization information system sentinel sites, located in Arizona, Michigan, Minnesota, Montana, Oregon, and the District of Columbia.

Researchers used the data from the sentinel sites to gauge compliance with a June 2006 ACIP recommendation, which called for routine influenza vaccination among children aged 6-59 months. The early data revealed that at all six sites less than 30% of children aged 6-23 months had been fully vaccinated and less than 20% of children aged 24-59 months were fully vaccinated against influenza during the 2006-2007 season (MMWR 2007; 56:963–5).

ELSEVIER GLOBAL MEDICAL NEWS

The insurance giant UnitedHealthcare could pay up to $20 million to state regulators to settle allegations that the company violated state laws in its claims processing.

Under the settlement, UnitedHealthcare has agreed to pay about $12.2 million up front to 36 states and the District of Columbia. Going forward, the payout could grow to $20 million if other states join the settlement.

UnitedHealthcare has also agreed to a 3-year process improvement plan that will run through the end of 2010. The company will be required to self-report data quarterly and annually on how it performs on a set of national performance standards. These benchmarks will focus on claims accuracy and timeliness, appeals review, and consumer complaint handling. A lack of compliance with the benchmarks could result in additional financial penalties, according to the National Association of Insurance Commissioners.

The settlement follows a multistate investigation that found errors in claims processing such as not applying correct fee schedules and deductibles. There were also frequent violations of prompt payment rules, according to the New York State Insurance Department, one of the lead parties in the settlement.

The settlement was praised by the National Association of Insurance Commissioners and the states involved. UnitedHealthcare also praised the settlement as evidence of how the industry can work with state regulators.

“This new, forward-thinking approach focuses the regulatory process for the states and our company on a practical set of uniform performance standards, while providing clearer and more meaningful means of assessing how well we are serving customers,” UnitedHealthcare CEO Kenneth A. Burdick said in a statement.

The District of Columbia and the following states signed on to the agreement: Alabama, Alaska, Arkansas, California, Connecticut, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, West Virginia, and Wyoming.

The insurance giant UnitedHealthcare could pay up to $20 million to state regulators to settle allegations that the company violated state laws in its claims processing.

Under the settlement, UnitedHealthcare has agreed to pay about $12.2 million up front to 36 states and the District of Columbia. Going forward, the payout could grow to $20 million if other states join the settlement.

UnitedHealthcare has also agreed to a 3-year process improvement plan that will run through the end of 2010. The company will be required to self-report data quarterly and annually on how it performs on a set of national performance standards. These benchmarks will focus on claims accuracy and timeliness, appeals review, and consumer complaint handling. A lack of compliance with the benchmarks could result in additional financial penalties, according to the National Association of Insurance Commissioners.

The settlement follows a multistate investigation that found errors in claims processing such as not applying correct fee schedules and deductibles. There were also frequent violations of prompt payment rules, according to the New York State Insurance Department, one of the lead parties in the settlement.

The settlement was praised by the National Association of Insurance Commissioners and the states involved. UnitedHealthcare also praised the settlement as evidence of how the industry can work with state regulators.

“This new, forward-thinking approach focuses the regulatory process for the states and our company on a practical set of uniform performance standards, while providing clearer and more meaningful means of assessing how well we are serving customers,” UnitedHealthcare CEO Kenneth A. Burdick said in a statement.

The District of Columbia and the following states signed on to the agreement: Alabama, Alaska, Arkansas, California, Connecticut, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, West Virginia, and Wyoming.

The insurance giant UnitedHealthcare could pay up to $20 million to state regulators to settle allegations that the company violated state laws in its claims processing.

Under the settlement, UnitedHealthcare has agreed to pay about $12.2 million up front to 36 states and the District of Columbia. Going forward, the payout could grow to $20 million if other states join the settlement.

UnitedHealthcare has also agreed to a 3-year process improvement plan that will run through the end of 2010. The company will be required to self-report data quarterly and annually on how it performs on a set of national performance standards. These benchmarks will focus on claims accuracy and timeliness, appeals review, and consumer complaint handling. A lack of compliance with the benchmarks could result in additional financial penalties, according to the National Association of Insurance Commissioners.

The settlement follows a multistate investigation that found errors in claims processing such as not applying correct fee schedules and deductibles. There were also frequent violations of prompt payment rules, according to the New York State Insurance Department, one of the lead parties in the settlement.

The settlement was praised by the National Association of Insurance Commissioners and the states involved. UnitedHealthcare also praised the settlement as evidence of how the industry can work with state regulators.

“This new, forward-thinking approach focuses the regulatory process for the states and our company on a practical set of uniform performance standards, while providing clearer and more meaningful means of assessing how well we are serving customers,” UnitedHealthcare CEO Kenneth A. Burdick said in a statement.

The District of Columbia and the following states signed on to the agreement: Alabama, Alaska, Arkansas, California, Connecticut, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, West Virginia, and Wyoming.

The number of Americans without health insurance reached 47 million last year, up from 44.8 million in 2005, according to new data released by the U.S. Census Bureau.

The percentage of individuals without health insurance also rose from 15.3% in 2005 to 15.8% in 2006.

This rise includes an increase in the number of uninsured children. The percentage and number of children under age 18 without health insurance increased from 8 million (10.9%) in 2005 to 8.7 million (11.7%) in 2006. Much of the increase in the uninsured rate for children can be attributed to a decline in private coverage, David Johnson, chief of the division of housing and household economic statistics at the Census Bureau, said during a news conference.

Overall, the percentage of individuals covered by any type of private insurance plan dropped from 68.5% in 2005 to 67.9% in 2006. And among children, the percentage with private coverage fell from 65.8% in 2005 to 64.6% in 2006, Mr. Johnson said.

At the same time, coverage by government insurance was also down from 27.3% in 2005 to 27% in 2006. The data are compiled from the 2007 Current Population Survey Annual Social and Economic Supplement.

The increase in the number of uninsured individuals between 2005 and 2006 is “pretty shocking,” said Karen Davis, Ph.D., president of The Commonwealth Fund, especially in a year when states have been under less financial pressure and many have been trying to expand coverage.

The deterioration of dependent coverage among private plans is particularly disturbing and points to the importance of reauthorizing the State Children's Health Insurance Program (SCHIP) with adequate funding, she said.

The number and percentage of uninsured children had been falling consistently between 1998 and 2004 but that progress began to reverse in 2005, said Robert Greenstein, executive director of the Center on Budget and Policy Priorities. These latest data from the Census Bureau show that the country is “losing significant ground” in insuring children, he said, and he called on President Bush to rethink his position on funding for SCHIP.

The number of Americans without health insurance reached 47 million last year, up from 44.8 million in 2005, according to new data released by the U.S. Census Bureau.

The percentage of individuals without health insurance also rose from 15.3% in 2005 to 15.8% in 2006.

This rise includes an increase in the number of uninsured children. The percentage and number of children under age 18 without health insurance increased from 8 million (10.9%) in 2005 to 8.7 million (11.7%) in 2006. Much of the increase in the uninsured rate for children can be attributed to a decline in private coverage, David Johnson, chief of the division of housing and household economic statistics at the Census Bureau, said during a news conference.

Overall, the percentage of individuals covered by any type of private insurance plan dropped from 68.5% in 2005 to 67.9% in 2006. And among children, the percentage with private coverage fell from 65.8% in 2005 to 64.6% in 2006, Mr. Johnson said.

At the same time, coverage by government insurance was also down from 27.3% in 2005 to 27% in 2006. The data are compiled from the 2007 Current Population Survey Annual Social and Economic Supplement.

The increase in the number of uninsured individuals between 2005 and 2006 is “pretty shocking,” said Karen Davis, Ph.D., president of The Commonwealth Fund, especially in a year when states have been under less financial pressure and many have been trying to expand coverage.

The deterioration of dependent coverage among private plans is particularly disturbing and points to the importance of reauthorizing the State Children's Health Insurance Program (SCHIP) with adequate funding, she said.

The number and percentage of uninsured children had been falling consistently between 1998 and 2004 but that progress began to reverse in 2005, said Robert Greenstein, executive director of the Center on Budget and Policy Priorities. These latest data from the Census Bureau show that the country is “losing significant ground” in insuring children, he said, and he called on President Bush to rethink his position on funding for SCHIP.

The number of Americans without health insurance reached 47 million last year, up from 44.8 million in 2005, according to new data released by the U.S. Census Bureau.

The percentage of individuals without health insurance also rose from 15.3% in 2005 to 15.8% in 2006.

This rise includes an increase in the number of uninsured children. The percentage and number of children under age 18 without health insurance increased from 8 million (10.9%) in 2005 to 8.7 million (11.7%) in 2006. Much of the increase in the uninsured rate for children can be attributed to a decline in private coverage, David Johnson, chief of the division of housing and household economic statistics at the Census Bureau, said during a news conference.

Overall, the percentage of individuals covered by any type of private insurance plan dropped from 68.5% in 2005 to 67.9% in 2006. And among children, the percentage with private coverage fell from 65.8% in 2005 to 64.6% in 2006, Mr. Johnson said.

At the same time, coverage by government insurance was also down from 27.3% in 2005 to 27% in 2006. The data are compiled from the 2007 Current Population Survey Annual Social and Economic Supplement.

The increase in the number of uninsured individuals between 2005 and 2006 is “pretty shocking,” said Karen Davis, Ph.D., president of The Commonwealth Fund, especially in a year when states have been under less financial pressure and many have been trying to expand coverage.

The deterioration of dependent coverage among private plans is particularly disturbing and points to the importance of reauthorizing the State Children's Health Insurance Program (SCHIP) with adequate funding, she said.

The number and percentage of uninsured children had been falling consistently between 1998 and 2004 but that progress began to reverse in 2005, said Robert Greenstein, executive director of the Center on Budget and Policy Priorities. These latest data from the Census Bureau show that the country is “losing significant ground” in insuring children, he said, and he called on President Bush to rethink his position on funding for SCHIP.