Studies in this issue of RAND Health Quarterly address every stage in the policy process—from descriptive research identifying policy issues and questions to comparisons of policy alternatives to policy evaluation. Each individual research study generates important new knowledge at each discrete stage in the policy process. At a broader level, however, policy-oriented research has the most profound impact when it tracks the policy process from the initial steps of problem formulation through long-term evaluations of its effects. Many researchers at RAND, academic institutions, and other research organizations appreciate this broad perspective and collaborate on studies spanning the entire policy process.
Several studies in this issue are aligned with earlier stages of the policy process, including studies proposing policy questions and characterizing potential policy problems using health services research and health economics methods. Each of these studies helps set the stage for potential changes to existing policy. For example, Buddin and Han identify potential mismatches between Department of Defense and Department of Veterans Affairs disability compensation and reductions in civilian earnings. Auerbach et al. model trends in the market for sexual and reproductive health services, focusing especially on nurse practitioners. Romley et al. estimate the impact of air pollution on hospital spending. Finally, Seabury and McLaren study the prevalence and impact of musculoskeletal disorders on California firefighters.
Other studies focus on elements of policy design and implementation in disparate topical areas. Thaler et al. help build a rationale and framework for U.S. Air Force health engagement missions to improve public health and health services capabilities in developing states. Kilmer et al. identify eight opportunities for improvement in the area of drug policy. Haims and Dick lay out four policy implementation alternatives to allow Medicare beneficiaries residing in Mexico to receive benefits in the lower-cost Mexican health care system. Linnemayer et al. propose options for negotiating prices for antiretroviral drugs to treat HIV/AIDS. Jackson et al. lay out a method for modeling emergency response systems that has utility to policymakers.
Finally, several studies in this issue of RAND Health Quarterly are ex post evaluations of health programs and policies. Schultz et al. evaluated the progress of seven health-related programs funded through the Arkansas Tobacco Settlement Proceeds Act. Chandra et al. found some positive effects from Operation Purple, a summer camp program for youth with a deployed parent. Krull and Haugseth evaluate the impact of programs provided by the not-for-profit Wounded Warrior Project organization across population subgroups.
Many of these studies, regardless of their particular focus along the policy process, introduce and explore upstream motivations and downstream implications of the research. These links serve an important purpose in placing individual studies in the broader policy process context.
Andrew W. Mulcahy, Ph.D., M.P.P., Editor