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Chronic Diseases and Conditions

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Chronic diseases and conditions such as HIV/AIDS, cancer, and chronic obstructive pulmonary disease (COPD) have long-lasting effects and costs and have prompted numerous health care reform efforts to target population health. RAND research on chronic diseases and conditions has examined the efficacy of workplace wellness programs, evaluated the effectiveness of the chronic care model, and made recommendations regarding the delivery of genomic medicine to those suffering from chronic disease.

Report
Policy Options for Covering High-Cost Cures
Strategic behavior by health insurers could unravel the market for cures for chronic diseases. The cost of these cures is front-loaded, but the benefits build up over time. Thus, insurers might try to delay treatment or avoid patients who need it, in the hope that they change insurers.
May 3, 2016
Essay
Chronic Conditions in America: Price and Prevalence
Sixty percent of U.S. adults have at least one chronic condition, and 12 percent have five or more. They account for hundreds of billions of dollars in health care spending every year.
Jul 12, 2017

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News Release
On World Sleep Day, New Research Reveals the Socioeconomic Impact of Insomnia on Global Populations
Insomnia is the most common sleep disorder and exacts a significant toll on an individual's mental and physical health, quality of life, and productivity. But the consequences of insomnia go well beyond the individual, with cascading effects on families, employers, and global economies.
Mar 17, 2023
Report
The societal and economic burden of insomnia in adults: An international study
This study sought to examine the societal and economic burden of insomnia through a literature review, secondary database analyses and economic modelling. Findings indicate a substantial burden.
Mar 16, 2023
Journal Article
Association Between Hospital-Physician Vertical Integration and Medication Adherence Rates
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.
Oct 28, 2022
Journal Article
Scaling Interventions to Manage Chronic Disease: Innovative Methods at the Intersection of Health Policy Research and Implementation Science
In December 2021, Johns Hopkins convened a forum of research experts to discuss approaches for studying policy implementation. In this report, we summarize the ideas that came out of the forum.
Oct 27, 2022
Report
Managing Urinary Incontinence for Women in Primary Care: Environmental Scan (Base Year)
The authors of this report present an environmental scan of studies that assess the dissemination and implementation of nonsurgical urinary incontinence treatments for women in primary care.
Oct 20, 2022
Journal Article
Diet Quality Improvement and 30-Year Population Health and Economic Outcomes: A Microsimulation Study
Microsimulation (Future Adult Model) predicted 30-year US population changes from improved diet quality. Diet improvement reduced prevalence of diabetes, heart disease and stroke by 11%, 7%, and 10%, and reduced healthcare costs by $144B in year 30.
Jul 12, 2022
Journal Article
Evaluation of a Home-Based, Nurse Practitioner–led Advanced Illness Care Program
Evaluation of a nurse-led, home-based serious illness care program (Advanced Illness Care) at UPMC, a health system in Pittsburgh, PA.
Jun 1, 2022
Journal Article
Clinicians' Perceptions of Collaborative Palliative Care Delivery in Chronic Kidney Disease
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.
Jun 1, 2022
Journal Article
Stepped Care for Depression at Integrated Chronic Care Centers (IC3) in Malawi: Study Protocol for a Stepped-Wedge Cluster Randomized Controlled Trial
This study will compare the effects of an evidence-based depression care model versus usual care on depression symptom remediation as well as physical health outcomes for chronic care conditions.
Mar 29, 2022
Journal Article
Do Financial Incentives Affect Utilization for Chronically Ill Medicare Beneficiaries?
We find that Medicare Advantage beneficiaries with chronic conditions respond to changes in copays, although these responses are small. Reductions in copays lead to reduced use of specialists, suggesting that lowering copays could be a way to reduce specialist care.
Mar 4, 2022
Journal Article
Challenges and Improvement Needs in the Care of Patients with Central Diabetes Insipidus
This paper contributes to a well-rounded understanding of clinical and healthcare systems-related challenges and improvement opportunities in the care of patients with a rare disease called central diabetes insipidus.
Mar 2, 2022
Journal Article
Income as a Predictor of Self-Efficacy for Managing Pain and for Coping With Symptoms Among Patients With Chronic Low Back Pain
The purpose of this study was to evaluate pain self-efficacy (PSE) and coping self-efficacy (CSE) for people with chronic low back pain, and to assess whether lower income may be associated with less PSE and CSE in the U.S.
Feb 25, 2022
Journal Article
Measuring the Appropriateness of Spinal Manipulation for Chronic Low Back and Chronic Neck Pain in Chiropractic Patients
The RAND/UCLA Appropriateness Method is applied to chiropractic manipulation for patients with chronic low-back pain and chronic neck pain, to determine the rate of appropriate care provided by U.S. chiropractors.
Feb 25, 2022
Journal Article
Predictors of Visit Frequency for Patients Using Ongoing Chiropractic Care for Chronic Low Back and Chronic Neck Pain: Analysis of Observational Data
An observational longitudinal study looking at visit frequency and outcomes for patients using ongoing chiropractic care for chronic low-back and neck pain.
Feb 25, 2022
Journal Article
A Rapid Evidence Assessment Exploring Whether Antimicrobial Resistance Complicates Non-Infectious Health Conditions and Healthcare Services, 2010–20
This study explored what impact AMR is currently having on non-communicable health conditions, or areas of health services, via a rapid evidence assessment of 101 studies.
Dec 3, 2021
Tool
Serious Illness Survey for Home-Based Programs
RAND Corporation researchers developed and field-tested a survey to assess the experiences of individuals who receive care from programs that provide serious illness care to patients in their homes.
Nov 2, 2021
Tool
Serious Illness Survey for Home-Based Programs: Spanish-Language Version
RAND Corporation researchers developed and field-tested a survey to assess the experiences of individuals who receive care from programs that provide serious illness care to patients in their homes. This is the Spanish version of the survey tool.
Nov 2, 2021
Commentary
The Informal Carers Who Help People with MS Need Support More Than Ever
The trend within health care services toward remote care and self-management for people with multiple sclerosis has not included adequate support to carers. Greater investment to support the needs of carers could support the informal care they provide, as well as the carer as an individual.
May 28, 2021
Project
What Do We Know About the Health and Well-Being of U.S. Service Members?
RAND experts have analyzed data from the Department of Defense's flagship survey for understanding the health, health behaviors, and well-being of service members. The results provide valuable insights across various health-related topics and about personnel by service branch.
Apr 28, 2021
Research Brief
2018 Health Related Behaviors Survey: Physical Health and Functional Limitations Among the Active Component
The 2018 Health Related Behaviors Survey sought information on the health and health behaviors of service members. This brief reviews results for physical health and functional limitations among active component members.
Apr 28, 2021

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RAND Topic:
Chronic Diseases and Conditions

Topic Synonyms:
Chronic Disease Management

Research conducted by

Researcher Spotlight

Robert J. Romanelli

Research Leader

Rob Romanelli (he/him) is a research leader at RAND Europe focusing on health and well-being. Romanelli's work has focused on evaluating health care system policies, programs, and interventions designed to improve the quality and safety of care delivery. He is broadly interested in the…
Christine Buttorff

Policy Researcher

Christine Buttorff (she/her) is a policy researcher at the RAND Corporation. Her primary research interests are in health insurance benefit design and prescription drug policy. She uses both qualitative and quantitative methods for the evaluation of policy interventions.

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