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.
Extends the literature devoted to private equity in healthcare by focusing on an influential and growing dimension of care (outpatient surgery) and key contributing industry (ambulatory surgery centers) where private equity has been aggressive.
In 2008–2017, 15–18% of U.S. primary care practices sought or maintained patient-centered medical home recognition. We interviewed a sample of 105 of these practices to determine why patient experience surveys were chosen.
This report presents an evaluation of California's psychiatric bed needs in 2021 and the coming years. California, like many states, is confronting a psychiatric bed shortage. To strategically build capacity, the state must understand its psychiatric bed needs. The authors examine California's adult bed capacity, need, and the gap between them at three levels of inpatient and residential care: acute, subacute, and community residential services.
Psychiatrists perceived that most patients are good candidates for telemedicine visits in the context of hybrid care models.
Increases in vertical integration were not associated with changes in medication adherence rates. However, adherence rates after vertical integration declined for non-Whites, patients over 80 years old, and patients with greater comorbidities.
This population-based cross-sectional study found that although quality of care and patient experience were slightly higher with higher-premium plans, quality varied widely within each premium category.
Mental health services provide essential supports to people living with psychiatric disorders. However, in the United States as a whole and in New York City in particular, the use of mental health services is low and care is not equitably distributed. To advance policy strategy for addressing gaps in the mental health services system, RAND researchers investigate the availability and accessibility of mental health services in New York City.
In interviews with clinicians, they expressed barriers to delivering chronic kidney disease care. To address barriers, clinicians outlined intervention points, such as building models, and structural triggers to identify patients who may be appropriate for palliative care.
This study aimed to examine the content of the recommendations given to providers aimed at improving provider-patient interactions, characterize these recommendations, and examine their actionability.
In early 2020, as the COVID-19 pandemic emerged, widespread social-distancing efforts suspended much of the delivery of nonurgent health care. Telehealth proved to be a viable alternative to in-person care, at least on a temporary basis, and utilization skyrocketed. Researchers investigated changes in telehealth utilization and health center staff experiences with implementation.
The purpose of this mixed-methods study was to examine and compare telehealth experiences among outpatient palliative care programs and their patients in the United States.
Shelter-in-place policies during the COVID-19 pandemic were associated with reductions in the use of preventive care, elective care, and the number of weekly visits to physician offices, hospitals and other health care-related industries.
Participants had highly favorable attitudes about the Chronic Care and Medicine Dispensing and Distribution (CCMDD) program for HIV treatment. Patient-level barriers to care included inadequate education about CCMDD and inability to get refills. Organizational-level barriers included challenges with communication and transportation, errors in medication packaging and tracking, rigid rules, and inadequate infrastructure.
Complementary and integrative health providers, such as chiropractors and naturopathic doctors, have been an underutilized public health asset in the response to the COVID-19 pandemic. This report seeks to inform how they can be better integrated into future responses to public health emergencies.
Although telehealth holds promise for promoting access to child and adolescent psychiatric services, large disparities in overall access to services persists in rural and low-income communities.
We conducted semi-structured interviews with 20 adults receiving care from one fully virtual opioid use disorder telemedicine service who had received three to five weeks of treatment.
We conducted a systematic search for English-language peer-reviewed articles after 2010 on differences in urban and rural care provided by U.S. HHAs. We screened 876 studies and conducted full-text abstraction and NOS quality review on 36 articles.
We examined use of and willingness to use video telehealth during the COVID-19 pandemic in a longitudinally followed cohort.
In this cohort study, 8 large pediatric medical groups in California collaborated to share aggregate data on telehealth use for 11 pediatric subspecialties from January 1, 2019, to December 31, 2021.
The 10Plan is a self-pay plan for individuals currently uninsured or covered by a private nongroup health insurance plan. The authors built a microsimulation model to estimate health care spending under both the status quo and the 10Plan.
