Top Priorities for the Next Decade of Nursing Health Services Research 2021
This article presents a Nursing Health Services Research agenda for the 2020s.
Publications on Health Care Organization and Capacity
RAND Health Care research on the organization and capacity of the health care system takes a broad perspective. Our work has examined how organization affects the system’s ability to provide high-quality care and to use resources efficiently and effectively. Many studies have focused on the link between health system organization and the ability of the public health system to respond to public health emergencies, whether natural or the result of hostile action.
2021
-
-
Treatment of Opioid Use Disorder During COVID-19: Experiences of Clinicians Transitioning to Telemedicine 2021
In the context of the pandemic, buprenorphine prescribers quickly transitioned to providing telemedicine visits in high volume; nonetheless, there are still many unknowns, including the quality and safety of widespread use of telemedicine for OUD treatment.
-
What Drives Greater Assimilation of Telestroke in Emergency Departments? 2021
Although many emergency departments (EDs) have telestroke capacity, it is unclear why some EDs consistently use telestroke and others do not. We compared the characteristics and practices of EDs with robust and low assimilation of telestroke.
2020
-
Understanding How Health Systems Facilitate Primary Care Redesign 2020
The objectives of this study are to understand how health systems are facilitating primary care redesign (PCR), examine the PCR initiatives taking place within systems, and identify barriers to this work.
-
Use of Tele–mental Health in Conjunction With In-Person Care: A Qualitative Exploration of Implementation Models 2020
Exploration of implementation models for tele–mental health.
-
What Are the Determinants of Health System Performance? Findings from the Literature and a Technical Expert Panel 2020
This study is part of an ongoing effort to discover how and why some health systems in the United States are high performing and others are not.
-
Association of Scheduled vs Emergency-Only Dialysis With Health Outcomes and Costs in Undocumented Immigrants With End-stage Renal Disease 2020
This article examines the association of scheduled vs emergency-only hemodialysis with health care outcomes and costs in undocumented immigrants with end-stage renal disease.
-
Impact of Project ECHO Models of Medical Tele-Education: A Systematic Review 2020
This systematic review examines the effectiveness of ECHO and ECHO-like medical tele-education models of healthcare delivery in terms of improved provider- and patient-related outcomes.
-
The Use of and Experiences With Telelactation Among Rural Breastfeeding Mothers: Secondary Analysis of a Randomized Controlled Trial 2020
The objective of this study was to identify maternal characteristics associated with the demand for and use of telelactation and to describe visit characteristics.
-
Use of Virtual Breastfeeding Support Among Underserved, Rural Mothers 2020
To assess predictors of utilization and telelactation visit characteristics, we merged and analyzed data from two sources: visit-level data supplied by the telelactation vendor and longitudinal surveys of women in the intervention group at four timepoints.
2019
-
Federally Qualified Health Center Strategies for Integrating Care with Hospitals and Their Association with Measures of Communication 2019
Health centers differ in the use of strategies to integrate care with hospitals. Overall, integration activity is associated with better communication.
-
Primary and Behavioral Health Care Integration Program: Impacts on Health Care Utilization, Cost, and Quality 2019
This report describes an extension of the RAND Corporation's evaluation of the Substance Abuse and Mental Health Services Administration's Primary and Behavioral Health Care Integration (PBHCI) grants program. The current study extends previous work by investigating the impact of PBHCI on consumers' health care utilization, total costs of care to Medicaid, and quality of care in three states.
-
Sharing and Integrating HIV Client Data Across Provider Organizations to Improve Service Coordination: A Toolkit 2019
Recognizing the potential power of close collaboration, two federal programs that provide support to low-income people with HIV came together to determine how they could integrate data to improve outcomes for individuals with HIV who also experience housing instability. This toolkit, the result of that project, is an effort to demystify the data integration process and help others share data and coordinate services across providers.
-
Understanding U.S. Health Systems: Using Mixed Methods to Unpack Organizational Complexity 2019
Researchers need qualitative data to understand how health systems actually work and influence clinical practice.
-
Addressing Social Determinants of Health Needs of Dually Enrolled Beneficiaries in Medicare Advantage Plans: Findings from Interviews and Case Studies 2019
Beneficiaries who are dually enrolled in Medicare and Medicaid are less likely to be enrolled in Medicare Advantage (MA) plans that perform well in the MA Star Rating program than non–dually enrolled beneficiaries. The authors identify the types of services that MA plans implement to meet the needs of dually enrolled and other high-cost, high-need beneficiaries, as well as the types of resources needed to implement these services.
-
A Comprehensive Theory of Integration 2019
This article presents a comprehensive theory describing how integrating structures, processes, and people within and across organizations might lead to integrated patient care and improved outcomes, including technical quality, efficiency, patient health, and both patient and provider experience.
2018
-
Integrating Department of Defense and Department of Veterans Affairs Purchased Care: Preliminary Feasibility Assessment 2018
The U.S. Department of Defense and U.S. Department of Veterans Affairs health systems operate purchased care programs that govern how beneficiaries see providers in their communities. This preliminary feasibility assessment examined how an integrated approach to purchasing care could affect access, quality, and costs and identified general legislative, policy, and contractual challenges to implementing such a program.
-
Preliminary Feasibility Assessment of DoD-VA Purchased Care Integration 2018
An integrated approach to purchasing health care for U.S. Department of Defense and U.S. Department of Veterans Affairs could have important implications for access, quality, and costs but could face legislative, policy, or contractual challenges.
-
Sustaining Alcohol and Opioid Use Disorder Treatment in Primary Care: A Mixed Methods Study 2018
Access to external funding and staff support are two important factors for the sustainability of substance use disorder treatment provision within primary care clinics.
2017
-
Sources of Care for Alcohol and Other Drug Problems: The Role of the African American Church 2017
Many Los Angeles-area African American churches provide recovery supports and services for alcohol and other drug (AOD) use and actively connect individuals to formal AOD treatment.