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Am Fam Physician. 2002;66(11):2037-2039

IOM Report Urges Federal Government to Standardize Quality of Health Care

A recent report by the Institute of Medicine (IOM) urges the federal government to standardize the quality-improvement efforts of the entire health care system. The committee that authored the report suggests that Congress direct the secretaries of the U.S. Department of Health and Human Services (HHS), the Department of Defense, and the Department of Veterans Affairs to work cooperatively to establish standardized performance measures across the six government health care programs: Medicare, Medicaid, the State Children's Health Insurance Program, the Department of Defense TRICARE programs, the Veterans Health Administration, and the Indian Health Service. These programs provide health insurance or medical services to about one third of Americans. In addition to setting minimum standards for the patient care provided by these programs, the report suggests that the federal government employ purchasing standards, such as higher payments and public recognition, to encourage health care professionals to adopt “best practices.” The report also recommends that the government collect and make available to the public data comparing the quality of care among providers. The report, “Leadership by Example: Coordinating Government Roles in Improving Health Care Quality,” was sponsored by the HHS, the California HealthCare Foundation, and the Commonwealth Fund. The full text of the report is available on the Internet at

Safety Net Legislation Passes, Reauthorizes Community Health Center Programs

President Bush recently signed into law the Health Care Safety Net Amendments of 2002, which reauthorizes the National Health Service Corps, the Community Health Centers, the Health Community Access Program, and several grants programs administered by the Office of Rural Health Policy. This bill also creates new programs that focus on quality improvement for small rural providers and on strengthening the rural emergency services system, and expands tele-health and dental programs. “With this legislation we're opening the door to new opportunities to improve the way underserved populations receive needed health services,” said HHS Secretary Tommy G. Thompson. “It couldn't be happening at a more critical time. This action follows the recent release of new data showing that the number of uninsured Americans rose last year by 1.4 million, to 41.2 million people.” The safety net legislation was passed by the Senate in April and the House of Representatives in October.

HHS Awards $85 Million to Support Elimination of Health Disparities

HHS Secretary Tommy G. Thompson recently announced the awarding of $85 million to help support the elimination of health disparities among racial and ethnic minority communities. The National Institutes of Health's (NIH) National Center on Minority and Health Disparities provided $74.5 million to be distributed among the following programs: the Centers of Excellence Program, the Endowment Program, the Research Infrastructure in Minority Institutions Program, and Loan Repayment Programs. The HHS' Office of Minority Health (OMH) awarded 65 grants totaling $10.5 million to support community and state-based efforts to eliminate human immunodeficiency virus/acquired immunodeficiency syndrome and other health disparities in racial and ethnic minority communities. A detailed listing of the NIH and OMH awards to institutions is available online at

‘Physicians with Heart’ Trip Delivers $10 Million of Medical Supplies to Uzbekistan

A delegation consisting of almost 50 members, including 22 family physicians, recently returned from the former Soviet republic of Uzbekistan, where it delivered nearly $10 million worth of pharmaceuticals and medical supplies to health facilities throughout the country. Delegation members helped distribute and document receipt of the medical supplies and pharmaceuticals and taught Uzbek health care professionals about family medicine. Educators for Advanced Life Support in Obstetrics also provided training for Uzbek physicians. Physicians with Heart is an international humanitarian project sponsored by a coalition of the American Academy of Family Physicians (AAFP), the AAFP Foundation, and Heart to Heart International, a humanitarian aid organization based in Olathe, Kan. The partnership's mission is to mobilize resources to improve health, to provide medical education, and to foster the development of family practice worldwide. Physicians with Heart has delivered more than $60 million in aid to former Soviet republics and Vietnam since 1993. For more information on the airlift, visit the AAFP Web site at

WHO Report Identifies Global Health Risks, Provides Intervention Strategies

A new report from the World Health Organization (WHO) identifies the major risk factors of disease, disability, and death worldwide, quantifies their impact from region to region, and provides examples of cost-effective ways to reduce those risks, even in poor communities. The report,” The World Health Report 2002: Reducing Risks, Promoting Healthy Life,” studied 25 major preventable risk factors, and found that the top 10 globally are childhood and maternal underweight; unsafe sex; high blood pressure; tobacco; alcohol; unsafe water, sanitation, and hygiene; high cholesterol levels; indoor smoke from solid fuels; iron deficiency; and overweight/obesity. According to the report, these 10 risks account for about 40 percent of the 56 million deaths that occur worldwide annually and one third of global loss of health life-years. The report predicts that unless action is taken, the number of deaths caused by these risks each year will increase dramatically by the year 2020. The report predicts that if all of these predictable risk factors are addressed as WHO recommends, health life spans could increase by as much as five years in the richer, developing countries, such as the United States, Europe, and Japan, and by as much as 16 plus years in parts of Africa, such as Malawi, where healthy life expectancy is currently as low as 37 years. The report can be read online at

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Copyright © 2002 by the American Academy of Family Physicians.

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