RAND Research Topic: Health Care Services Capacity

RAND COMPARE Releases Revised Website

Jul 20, 2011

Policymakers are facing new challenges as they implement the Patient Protection and Affordable Care Act (ACA). RAND COMPARE is a modeling tool that simulates the impact of implementation decisions on insurance coverage, premiums, and health care spending.

Caring for the Uninsured: What Role Do Emergency Rooms Play?

Oct 9, 2012

Absent from the discussion about health care during the first debate between President Barack Obama and Governor Mitt Romney was any mention of one of the main providers of care for America's uninsured: emergency rooms. What does research tell us about the use of ERs and the relevant implications on health care access and cost?

Co-Ops: A Very Tall Order

Aug 19, 2009

Cooperatives are a very tall order: a new type of organization, never before tested on a large scale, meant to fix the apparently intractable problems of high and rising costs, barriers to access and poor quality care, writes Elizabeth McGlynn.

NHS 24/7: An Effective Way to Improve Quality of Care?

May 24, 2013

There are proposals to have England's National Health Service offer non-emergency service on weekends. Since there is a strong association between the health and well-being of staff and the quality of patient care, 24/7 working could have unintended consequences for patients.

Some Hospital Emergency Department Visits Could Be Handled by Alternative Care Settings

Sep 7, 2010

About 17 percent of all visits to hospital emergency departments across the United States could be treated at retail medical clinics or urgent care centers, potentially saving $4.4 billion annually in health care costs.

California Faces Challenges Meeting Health Needs of Offenders Released from Prison

Nov 16, 2011

With the health care safety net in California under stress from the state's continuing financial crisis, jurisdictions across the state face unprecedented challenges caring for the health and social service needs of people released from state prisons.

More Young People Are Becoming Nurses; Trend May Help Ease Future Nursing Shortage

Dec 5, 2011

The number of people aged 23 to 26—primarily women—who became registered nurses increased by 62 percent from 2002 to 2009, approaching numbers not seen since the mid-1980s. This trend should ease some of the concern about a looming nursing shortage in the United States.

Health Care Reform for Children and Families: Refinancing and Restructuring the U.S. Child Health System

Jan 1, 1996

This chapter examines the key issues underlying the discrepancies between the needs of children and families and the current and evolving structure of health services in the U.S. The authors look at the characteristics of the U.S. health care system that influence children's access to care and describe ways that emerging models of care can be modified to provide more efficient and effective health services for children.

Competition Under Fixed Prices: Effects on Patient Selection and Service Strategies by Hemodialysis Providers

Sep 1, 1996

Dialysis services for patients with end-stage renal disease (ESRD) are delivered by predominantly private providers competing in local markets.

Routine Emergency Department Use of Sick Care By Children in the United States

Jan 1, 1996

The use of emergency departments as a regular source of sick care has been increasing, even though it is costly and often an inappropriate source of care.

Balancing Act: Clinical Practices That Respond to the Needs of Homeless People

Jan 1, 1999

The paper concludes with comments on how to address the threats that challenge successful continuation of the unique approach to homeless health care that has evolved.

Will Public Health's Response to Terrorism Be Fair? Racial/ethnic Variations in Perceived Fairness During a Bioterrorist Event

Jan 1, 2004

Public health departments' effectiveness during catastrophic bioterrorism will require trust on the part of diverse communities.

The Cost of an Emergency Department Visit and Its Relationship to Emergency Department Volume

Jan 1, 2005

Findings suggest that the marginal cost of an outpatient ED visit is higher than is generally believed. Hospitals thus need to carefully review how EDs fit within their overall operations and cost structure and may need to pay special attention to policies and procedures that guide the delivery of nonurgent care through the ED.

Exploratory Factor Analyses of the CAHPS Hospital Pilot Survey Responses Across and Within Medical, Surgical, and Obstetric Services

Jan 1, 2005

Variability of CAHPS scores across hospitals can be reported parsimoniously using a limited number of composites.

Organizational Culture and Physician Satisfaction with Dimensions of Group Practice

Jan 1, 2007

Some dimensions of physician organizational culture are significantly associated with various aspects of individual physician satisfaction with group practice.

Nurse Working Conditions and Patient Safety Outcomes

Jun 1, 2007

Nurse working conditions were associated with all outcomes measured. Improving working conditions will most likely promote patient safety. Future researchers and policymakers should consider a broad set of working condition variables.

Nurse Working Conditions, Organizational Climate, and Intent to Leave in ICUs: An Instrumental Variable Approach

Jan 1, 2007

OC is an important determinant of ITL among ICU nurses. Because higher wages do not reduce ITL, increased pay alone without attention to OC is likely insufficient to reduce nurse turnover. Implementing interventions aimed at creating a positive OC, as found in Magnet hospitals, may be a more effective strategy.

States' Early Experience in Improving Systems-Level Care for Persons with Co-Occurring Disorders

Jan 1, 2007

This column discusses the experiences of the original cohort of seven states participating in the first two years of a national demonstration project known as the Co-occurring State Incentive Grant (COSIG) initiative.

Estimating the Potential Impact of Regionalizing Health Care Delivery Based on Volume Standards Versus Risk-Adjusted Mortality Rate

Jan 1, 2007

To examine whether basing regionalization on risk-adjusted mortality would lead to better population outcomes than basing regionalization on procedure volume.

The Evolution of Changes in Primary Care Delivery Underlying the Veterans Health Administration's Quality Transformation

Jan 1, 2007

Although VA's quality transformation had many underlying causes, investment in primary care development may have served as an essential substrate for many VA quality gains.