Current Projects: Health and Healthcare

Can ARVs Be Used to Prevent HIV/AIDS?

Many complex issues surround the use of antiretroviral (ARV) therapy as HIV prevention, and seen in the recent U.S. Food and Drug Administration decision to consider an ARV drug not just for HIV treatment but also to prevent HIV/AIDS. RAND Europe is partnering with several organisations on Mapping Pathways, a project exploring potential treatment regimes and conducting research, community engagement, and policy work in the U.S., India, and South Africa.

Could the Strengthening of Health Systems in Africa Improve Industrial Development?

The performance of health systems is a key determinant of the inclusiveness of economic growth. Exclusionary, poor quality health care worsens impoverishment, while inclusive health care redistributes the benefits of growth toward the poor and ill. With Kenya and Tanzania as case studies, RAND Europe is exploring the extent to which unexploited potential synergies between industrial development and health systems can strengthen and contribute to faster and more inclusive growth?

Evaluation of Drug and Alcohol "Payment by Results" Pilots

At a time of reduced public spending there is interest in funding public services on a ‘payment by results’ basis — under which the government pays for services only if and when they achieve defined outcome. The Department of Health has asked a consortium that includes RAND Europe to conduct an independent evaluation of DH's drug and alcohol recovery payment-by-results pilots. The goal is to determine whether market forces can encourage the development of better recovery programmes.

Examining Health and Safety in the European Workplace

RAND Europe is currently undertaking an analysis of the European Enterprise Survey (ESENER) on health and safety in the European workplace, for the European Health and Safety Agency (EU-OSHA). This work aims to understand the factors associated with the effective management of general occupational health and safety, as well as the specific management of psychosocial risks in enterprises.

Can Survey Data Help to Improve Patient Experience in Primary Care?

To understand how patient experience surveys can be used to improve care, a five-year programme will investigate the extent to which practice-based results mask individual variation between doctors, and how practices respond to scores which show a need for improvement. The research, which builds on ongoing work to validate the English GP Patient Survey, will include studies to help understand low scores among ethnic minorities and focus on continuity of care and doctor-patient communication.

Validation of the General Practitioner Patient Survey

The Department of Health surveys 5 million patients annually through its GP Patient Surveys. RAND Europe and CCHSR are examining the validity and reliability of the survey, analysing experiences of different population groups, and exploring the need for case mix adjustment. The team is also investigating the responses of patients and practices to the survey and identifying how the survey addresses relevant experiences of young people and offenders in the prison/probation service.

Mapping the Effective Treatment of Osteoporosis

Osteoporosis is the most common clinical disorder of bone metabolism—there are about 1,700 osteoporotic fractures per day across the European Union—yet evidence about the most effective methods to prevent and treat osteoporosis remains mixed. Amgen has commissioned RAND Europe to map the gaps in the evidence base and management practices across Europe. This work aims to inform the development of evidence-based quality indicators for the management of postmenopausal osteoporosis.

A Rapid Evidence Assessment for Understanding Public Acceptance of Behaviour Interventions

Some policy interventions are better able to change personal behaviour than others. RAND Europe, as part of the University of Cambridge Behaviour and Health Research Unit, is exploring whether contextual factors and the nature of evidence influence a policy’s acceptability and success. A Rapid Evidence Assessment developed by the RAND team to ensure the delivery of policy-relevant conclusions will focus on four key behaviours: smoking, diet, physical activity and alcohol consumption.

Assessing the Evidence Base for Pharmaceutical R&D Models

As research-based drug development is widely viewed as crucial to improving patient health, the pharmaceuticals sector is heavily reliant — and spends a great deal — on research and development. However, there is considerable debate about different R&D models: for example, is it more successful when conducted in a closed, in-house environment or through open networks and partnerships? To help answer this question, Pfizer has asked RAND Europe to investigate the evidence base.

Modeling the Economic Benefits of Malaria Control in Sub-Saharan Africa

Because malaria causes significant health problems and can also impair economic and social development in some parts of the world, large-scale prevention programmes have the potential to contribute considerably to sustainable economic development. RAND Europe is working to enhance computable models that take into account the many interactions throughout an economy, to include health benefits impacts and understand how economies may respond to different malaria control strategies.

How Much Would Expanding the Walking for Health Programme Cost?

To inform Natural England on the range of estimated costs associated with a possible expansion of its Walking for Health programme, RAND Europe, in collaboration with colleagues from the Health Economics Group of the University of East Anglia, is estimating the cost of six proposed schemes. The project will scope costs associated with the setting and running of the each scheme through developing a costing template to help structuring the types of costs associated with the schemes.

Researchers Offer "On-Call Facility" for International Healthcare Comparisons

Recognising that robust information on health systems in other countries can provide valuable lessons for the British National Health Service, the Department of Health has commissioned a team of researchers at RAND Europe and the London School of Hygiene and Tropical Medicine to create the "On-Call Facility" for International Healthcare Comparisons.

Engaging Clinicians in Improving Healthcare Quality

Governments in the UK have attempted to establish quality improvements, however without ownership and without being embedded in the organizational life of clinicians, the new procedures often fostered ill feeling and may have encouraged perverse behaviour. The Health Foundation launched a major study on how to engage clinicians in different disciplines in improving the quality of the healthcare they provide. RAND Europe has been asked to evaluate the outcomes when the study is completed in three years time. We will have the UK's most extensive systematic body of evidence on engaging clinicians in quality improvement.

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Ellen Nolte, Director, Health and Healthcare, RAND Europe