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.
A randomized controlled trial in Nigeria evaluated an intervention that paid pregnant women to deliver in a health facility, which led to a 41% increase in facility deliveries. We found improvements in the quality of delivery care and in satisfaction with care.
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.
Health centers differ in the use of strategies to integrate care with hospitals. Overall, integration activity is associated with better communication.
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.
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.
Researchers need qualitative data to understand how health systems actually work and influence clinical practice.
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.
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.
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.
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.
Access to external funding and staff support are two important factors for the sustainability of substance use disorder treatment provision within primary care clinics.
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.
The Gulf Cooperation Council countries experience an alarming increase chronic disease, yet their health care systems are ill-prepared to handle that burden. We recommend that they pioneer a health care delivery model based on population health management principles and sophisticated health information technology, rather than copy existing Western models.
Examines how California's ambulatory surgical centers (ASCs) compare with hospital outpatient surgery departments and how the state compares with other states in regulating ASCs.
