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Lessons from 9/11 for Supporting Veterans Exposed to Military Environmental Hazards: Veterans' Issues in Focus. 从 9/11 事件中吸取教训，为受到军事环境危害的退伍军人提供支持：聚焦退伍军人问题。
Rand health quarterly Pub Date : 2024-09-25 eCollection Date: 2024-09-01
Ramya Chari, Heather Marie Salazar, Lauren Skrabala
{"title":"Lessons from 9/11 for Supporting Veterans Exposed to Military Environmental Hazards: Veterans' Issues in Focus.","authors":"Ramya Chari, Heather Marie Salazar, Lauren Skrabala","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Exposure to environmental hazards exacerbates the risks inherent in military service, but many veterans do not experience the health consequences until many years later. The 2022 Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics (PACT) Act tasked the U.S. Department of Veterans Affairs with streamlining benefits and health care eligibility for certain veterans who have been exposed to military hazards. However, questions and concerns remain about the equitability, scientific robustness, and timeliness of the associated decisionmaking processes. There are opportunities to use structures from existing programs-specifically, the World Trade Center Health Program-as a template to improve engagement with veterans and their families, caregivers, providers, and advocates to ensure that their experiences and needs are heard, understood, and an integral part of the PACT Act's implementation.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"11 4","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The State of Health and Health Care for LGBTQ+ Veterans: Differences Among Sexual and Gender Minority Veterans, by Identity and State Policy Climate, 2015-2021. LGBTQ+ 退伍军人的健康和医疗状况：2015-2021 年按身份和州政策环境划分的性少数群体和性别少数群体退伍军人的差异。
Rand health quarterly Pub Date : 2024-09-25 eCollection Date: 2024-09-01
Megan S Schuler, Michael S Dunbar, Elizabeth Roth, Joshua Breslau
{"title":"The State of Health and Health Care for LGBTQ+ Veterans: Differences Among Sexual and Gender Minority Veterans, by Identity and State Policy Climate, 2015-2021.","authors":"Megan S Schuler, Michael S Dunbar, Elizabeth Roth, Joshua Breslau","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The U.S. government has affirmed commitments to improving health and well-being for lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) veterans, who may have distinct needs and challenges when accessing timely and appropriate health care. To date, there are limited data about potential health disparities among LGBTQ+ veterans that examine differences by both sexual identity and gender identity. Understanding the nature and magnitude of disparities among LGBTQ+ veterans is critical for targeted efforts to improve their health and well-being. The authors of this study use nationally representative data from 2015-2021 from the Behavioral Risk Factor Surveillance System to compare the age-adjusted prevalence of health-related outcomes across multiple domains (health care access and affordability, general health, substance use, and chronic conditions) for sexual and gender minority veterans with that of their heterosexual and cisgender veteran peers. LGBTQ+ veterans showed poorer health-related outcomes in multiple domains than their heterosexual and cisgender peers, including in terms of healthcare affordability, mental health, chronic cardiovascular conditions, and chronic respiratory conditions. The authors also examine associations between state LGBTQ+ policy climates and health-related outcomes among LGBTQ+ veterans. Among LGBTQ+ veterans, living in a state with a more favorable (versus negative) LGBTQ+ policy climate was associated with several health indicators (e.g., having health insurance, lower smoking rates). The authors then discuss implications for ongoing efforts to improve health and well-being for LGBTQ+ veterans, including sustained actions to ensure that all LGBTQ+ veterans are able to access necessary care and use the full scope of benefits for which they are eligible.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"11 4","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation Design for the Department of the Air Force's True North Program: Development of a Logic Model and Program Measures. 空军部 "真正北方 "计划的评估设计：开发逻辑模型和计划措施。
Rand health quarterly Pub Date : 2024-06-03 eCollection Date: 2024-06-01
Miriam Matthews, Thomas E Trail, Samantha E DiNicola, Coreen Farris, Jenna W Kramer, Isabelle González
{"title":"Evaluation Design for the Department of the Air Force's True North Program: Development of a Logic Model and Program Measures.","authors":"Miriam Matthews, Thomas E Trail, Samantha E DiNicola, Coreen Farris, Jenna W Kramer, Isabelle González","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Developing strong resiliency and care solutions for airmen and guardians is key to human capital development and force readiness. The True North program is one of the Department of the Air Force's (DAF's) most significant recent investments in promoting the resiliency of its people. Assessing the program's level of success, justifying funding, and informing decisions about the program's future will require a rigorous evaluation. The authors of this study (1) identify desired outcomes for members participating in the program, (2) define appropriate measures of effectiveness that could be used in evaluating the True North program, and (3) make recommendations for ongoing internal evaluation of the program. The True North program encompasses selected installation welcome centers, embedded religious support teams (RSTs), and embedded mental health (EMH) teams. To determine how DAF might evaluate this program and its components, the authors reviewed relevant policies and procedures and literature relevant to the program components and conducted interviews with 17 True North program personnel and 21 group and squadron commanders. They present a program logic model to determine potential evaluation measures.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"11 3","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Letter from the Editor. 编辑来信
Rand health quarterly Pub Date : 2024-06-03 eCollection Date: 2024-06-01
{"title":"Letter from the Editor.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"11 3","pages":"letter"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparing New Prescription Drug Availability and Launch Timing in the United States and Other OECD Countries. 比较美国和其他经合组织国家的新处方药供应和上市时间。
Rand health quarterly Pub Date : 2024-06-03 eCollection Date: 2024-06-01
Andrew W Mulcahy
{"title":"Comparing New Prescription Drug Availability and Launch Timing in the United States and Other OECD Countries.","authors":"Andrew W Mulcahy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Prescription drug research and development is, particularly in its most expensive later stages, an increasingly global endeavor undertaken by large, multinational firms. However, the availability of the resulting new drugs in individual countries and the timing of their launch can vary because of regulatory differences, business decisions, and other factors. The now-enacted Inflation Reduction Act of 2022 and other policy proposals aim to lower U.S. prices for brand-name drugs that are between three and four times as expensive as in other higher-income countries. Some stakeholders assert that lower U.S. prices will prevent U.S. patients from accessing some drugs sold in other countries or delay the launch of new drugs in the United States. To address these concerns, the author uses 2018 to 2022 data to compare the availability and timing of entry of new prescription drugs between the United States and other high-income countries.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"11 3","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the Impact of Individual Market Reforms in Minnesota. 评估明尼苏达州个人市场改革的影响。
Rand health quarterly Pub Date : 2024-06-03 eCollection Date: 2024-06-01
Preethi Rao, Federico Girosi, Christine Eibner
{"title":"Assessing the Impact of Individual Market Reforms in Minnesota.","authors":"Preethi Rao, Federico Girosi, Christine Eibner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Starting in 2026, Minnesota could experience disruptions to its health insurance marketplace caused by the anticipated sunset of federal premium subsidy enhancements, made available through the Inflation Reduction Act of 2022, as well as the expiration of state funding for its reinsurance program. With reduced premium subsidies, fewer people might enroll in marketplace plans, which could lead to higher premiums and market instability. The expiration of reinsurance, which partially offsets insurers' claims costs for people with high expenditures, could exacerbate these issues. In this study, researchers estimate the effects of implementing state-funded subsidies to bolster Minnesota's marketplace given these anticipated changes. They also study the impact of replacing the state's Basic Health Program with a similarly structured marketplace plan. The policy reforms that researchers consider were developed by the Minnesota Council of Health Plans and share similar goals with legislation recently proposed by Minnesota policymakers, such as HF 96, a bill authorizing study of a public option that also proposed to temporarily enhance marketplace subsidies.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"11 3","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving Trauma and Critical Care Proficiency and Readiness for Air Force Personnel in Critical Medical Specialties: A Pacific Air Forces Perspective. 提高空军关键医疗专业人员的创伤和重症监护能力并为其做好准备：太平洋空军的视角。
Rand health quarterly Pub Date : 2024-06-03 eCollection Date: 2024-06-01
Lisa M Harrington, Edward W Chan, Carl Berdahl, Matthew Walsh, Sean Mann, Jonah Kushner, Shreyas Bharadwaj, Mark Toukan, Thomas Goughnour
{"title":"Improving Trauma and Critical Care Proficiency and Readiness for Air Force Personnel in Critical Medical Specialties: A Pacific Air Forces Perspective.","authors":"Lisa M Harrington, Edward W Chan, Carl Berdahl, Matthew Walsh, Sean Mann, Jonah Kushner, Shreyas Bharadwaj, Mark Toukan, Thomas Goughnour","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Most U.S. Air Force medical personnel spend their time at military treatment facilities (MTFs) caring for patients whose ailments are far less complex or urgent than the severe trauma-related injuries they would see in war. This mismatch between peacetime and wartime medical care necessitates a deliberate effort on the part of the Air Force Medical Service (AFMS) as a whole and the Pacific Air Forces (PACAF) to ensure that personnel in critical medical specialties receive the training and hands-on clinical experience they need to save lives in a high-casualty environment. The goal of this research project was to investigate approaches for increasing readiness and proficiency. To develop a portfolio of readiness building activities, the authors analyzed manpower and personnel data, reviewed Comprehensive Medical Readiness Program (CMRP) checklists and relevant literature, engaged in discussions with the stakeholder community, and developed models of the assignment system and of skill acquisition and decay. They present their findings and recommendations for the future and have developed a prototype framework to demonstrate a possible method for deciding which readiness building activities and assignment policies to employ.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"11 3","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Outcome Assessments and Digital Health Technologies Supporting Clinical Trial Endpoints in Early Parkinson's Disease: Roundtable Proceedings and Roadmap for Research. 支持早期帕金森病临床试验终点的临床结果评估和数字健康技术：圆桌会议记录和研究路线图。
Rand health quarterly Pub Date : 2024-06-03 eCollection Date: 2024-06-01
Claire E O'Hanlon, Carrie M Farmer, Jamie Ryan, Natalie Ernecoff
{"title":"Clinical Outcome Assessments and Digital Health Technologies Supporting Clinical Trial Endpoints in Early Parkinson's Disease: Roundtable Proceedings and Roadmap for Research.","authors":"Claire E O'Hanlon, Carrie M Farmer, Jamie Ryan, Natalie Ernecoff","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article summarizes the Parkinson's Disease (PD) Endpoints Roundtable, which was held in Washington, D.C., on November 2-3, 2022, and hosted by The Michael J. Fox Foundation for Parkinson's Research, Parkinson's UK, and Parkinson Canada. This event brought representatives from academia and industry together with those from regulatory agencies, community partners, and research funders to discuss challenges in clinical outcome assessment development for treatments in early PD and to identify priorities for the field and opportunities for collaboration. This article provides a summary of the presentations given and topics discussed at the roundtable and synthesizes the discussions about the development of clinical outcome assessments and the use of digital health technologies for developing clinical trial endpoints.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"11 3","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparing Insulin Prices in the United States to Other Countries: Updated Results Using 2022 Data. 美国与其他国家的胰岛素价格比较：使用 2022 年数据得出的最新结果。
Rand health quarterly Pub Date : 2024-06-03 eCollection Date: 2024-06-01
Andrew W Mulcahy, Daniel Schwam
{"title":"Comparing Insulin Prices in the United States to Other Countries: Updated Results Using 2022 Data.","authors":"Andrew W Mulcahy, Daniel Schwam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Manufacturers' list prices for insulin have increased dramatically over the past decade in the United States. In this study, the authors present results from a comparison of U.S. and international prices for insulins using a price index approach. They compare prices for all insulins and different categories of insulin in the United States and 33 comparison Organisation for Economic Co-operation and Development countries. They present separate comparisons using U.S. manufacturer gross prices reflected at pharmacies and estimated manufacturer net prices after applying rebates paid by manufacturers. This study updates a prior RAND Corporation study, <i>Comparing Insulin Prices in the United States to Other Countries: Results from a Price Index Analysis</i>, with more-recent data and includes new supplementary analyses, editorial changes, and updates to reflect the evolving insulin market landscape.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"11 3","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Road to 988/911 Interoperability: Three Case Studies on Call Transfer, Colocation, and Community Response. 通往 988/911 互操作性之路：关于呼叫转移、主机托管和社区响应的三个案例研究。
Rand health quarterly Pub Date : 2024-06-03 eCollection Date: 2024-06-01
Stephanie Brooks Holliday, Samantha Matthews, Wendy Hawkins, Jonathan H Cantor, Ryan K McBain
{"title":"The Road to 988/911 Interoperability: Three Case Studies on Call Transfer, Colocation, and Community Response.","authors":"Stephanie Brooks Holliday, Samantha Matthews, Wendy Hawkins, Jonathan H Cantor, Ryan K McBain","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The 988 Suicide and Crisis Lifeline-known more simply as 988-holds promise for significantly improving the mental health of Americans and accelerating the decriminalization of mental illness. However, the rapid transition to 988 has left many gaps as communities scramble to prepare-not the least of which includes determining how 988 will interface with local 911 response systems and law enforcement. 911 is often the default option for individuals experiencing mental health emergencies, despite the fact that 911 call centers have limited resources to address behavioral health crises. Since 988 launched in 2022, one key area of focus has been ways that jurisdictions approach 988/911 interoperability: the existence of formal protocols, procedures, or agreements that allow for the transfer of calls from 988 to 911 and vice versa. This study presents case studies from three jurisdictions that have established models of 988/911 interoperability. It provides details related to interoperability in each model, including the role of each agency, points of interagency communication, and decision points that can affect the way a call flows through the local system. It also identifies facilitators, barriers, and equity-related considerations of each jurisdiction's approach, as well as lessons learned from implementation. This study should be of interest to jurisdictions that are looking to implement 988/911 interoperability, including those that are spearheading local initiatives and those that are responding to state-level legislation. Its findings are relevant to 988 call centers, public safety answering points, mobile crisis units, law enforcement, and local and state decisionmakers.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"11 3","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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