This issue of RAND Health Quarterly covers two main areas of research. The first half of this issue includes several studies focusing on the military health system. The military health system has a unique mission: It must provide health support to the full range of military operations and sustain the health of all who are entrusted to its care. More than 9 million beneficiaries are eligible for care through a system of military-owned treatment facilities, which includes facilities and clinics operated in military theaters and on military installations around the globe, as well as care purchased from the U.S. civilian sector through very large managed care support contracts. For more than ten years, the military health system has been supporting two major military operations, including deploying and operating forward medical assets in Iraq and Afghanistan and transforming trauma care, including advancements in en-route and in-air intensive care, amputee care and rehabilitation, and improved screening and treatment for the invisible wounds of war. At the same time, it has also provided care to a growing military beneficiary population during a time of intense growth in health care costs.
The studies included in this issue cover various aspects related to ensuring an efficient and high-quality military health system. Three studies focus specifically on issues critical to the Air Force's medical service: one examining the statuses of each of the seven Air Force medical and professional officer corps with regard to workforce management, one examining cost-effective means to ensure readiness of the Air Force's medical service, and one on improving medical planning for managing patient flow during expeditionary missions. Two studies assess potential cost-savings opportunities through better alignment of medical distribution structures for providing in-theater deployable medical support, one on equipping strategies for combat support hospitals (mobile, deployable hospitals housed in tents and expandable containers) and one examining the medical supply chain for moving critical medical supplies into theater. Two other studies focus on issues of particular relevance to the reserve component of the military, one on improving medical readiness and one on health care coverage for these weekend warriors who have been called on to deploy in unprecedented ways in the past decade. Other studies focus on assessing and optimizing use of the Department of Defense Serum Repository, approaches to reduce off-duty vehicle crashes among military personnel, and the development of a tool to support local civilian and military disaster planning and preparedness.
The second half of this issue of RHQ covers significant topical and methodological breadth. One study furthers clinical decision support (CDS) efforts by describing a prototype CDS knowledge-sharing service. Another two studies focus on alcohol pricing and illicit drug policies in Europe. Other studies propose a new pharmaceutical business model, describe declines in mortality from noncommunicable disease, evaluate the effect of Massachusetts health reform on workers' compensation hospital care, and review evidence related to osteoporosis prevention and treatment.
Terri Tanielian, Guest Editor
Andrew Mulcahy, Editor