Rand health quarterly最新文献_第9页

Environmental Scan on Consolidation Trends and Impacts in Health Care Markets. 医疗保健市场整合趋势和影响的环境扫描。

Rand health quarterly Pub Date : 2023-06-01 DOI: 10.7249/rra1820-1

Jodi L. Liu, Z. Levinson, Annetta Zhou, Xiaoxi Zhao, PhuongGiang Nguyen, N. Qureshi

{"title":"Environmental Scan on Consolidation Trends and Impacts in Health Care Markets.","authors":"Jodi L. Liu, Z. Levinson, Annetta Zhou, Xiaoxi Zhao, PhuongGiang Nguyen, N. Qureshi","doi":"10.7249/rra1820-1","DOIUrl":"https://doi.org/10.7249/rra1820-1","url":null,"abstract":"The No Surprises Act (NSA) was created to help protect consumers with private insurance from surprise medical bills from out-of-network health care providers. The NSA requires the Department of Health and Human Services to prepare annual reports to Congress on the effects of the NSA's provisions. This article summarizes findings of an environmental scan on consolidation trends and impacts in health care markets. It describes the evidence on price, spending, quality of care, access, and wages in health care provider and insurance markets, as well as other market trends. The authors found strong evidence that hospital horizontal consolidation is associated with higher prices paid to providers and some evidence of the same for vertical consolidation of hospitals and physician practices. Health care spending is likely to increase in tandem with these price increases. Most studies find decreased or no change in quality of care associated with consolidation; however, findings differ by quality measures examined and setting. Horizontal consolidation of commercial insurers is associated with lower prices paid to providers as insurers gain market power in negotiations with providers, but the lower prices paid to providers do not appear to be passed onto consumers, who face higher premiums following insurer consolidation. There is insufficient evidence of the effects on patient access to care and health care wages. The few evaluations of state surprise billing laws have found heterogeneous effects on prices and have not directly examined effects on spending, quality, patient access, and wages.","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"10 3 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46027670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Promise and Challenges of VA Community Care: Veterans' Issues in Focus. 退伍军人事务部社区护理的前景和挑战：退伍军人问题的焦点。

Rand health quarterly Pub Date : 2023-06-01 DOI: 10.7249/pea1363-5

P. Rasmussen, Carrie M. Farmer

引用次数: 3

The Promise and Challenges of VA Community Care: Veterans' Issues in Focus. 退伍军人社区护理的承诺和挑战:退伍军人问题的焦点。

Rand health quarterly Pub Date : 2023-06-01

Petra Rasmussen, Carrie M Farmer

引用次数: 0

Sexual Assault Experiences in the Active-Component Army: Variation by Year, Gender, Sexual Orientation, and Installation Risk Level. 现役部队的性侵经历：按年份、性别、性取向和设施风险水平的变化。

Rand health quarterly Pub Date : 2023-06-01 DOI: 10.7249/rra1385-2

A. Calkins, M. Cefalu, Terry L. Schell, Linda Cottrell, Sarah O. Meadows, R. Collins

{"title":"Sexual Assault Experiences in the Active-Component Army: Variation by Year, Gender, Sexual Orientation, and Installation Risk Level.","authors":"A. Calkins, M. Cefalu, Terry L. Schell, Linda Cottrell, Sarah O. Meadows, R. Collins","doi":"10.7249/rra1385-2","DOIUrl":"https://doi.org/10.7249/rra1385-2","url":null,"abstract":"To better understand the circumstances surrounding sexual assault in the Army, RAND Arroyo Center researchers created descriptions of active-component soldiers' most serious sexual assault experiences using data from the 2016 and 2018 Workplace and Gender Relations Survey of Active Duty Members. In this study, researchers describe the most common types of behaviors that occurred, characteristics of alleged perpetrators, and times and places in which the experiences occurred. They also explore differences by gender, sexual orientation, and installation risk level. Nearly 90 percent of victims believed that the assault was committed for a sexual reason, and more than half indicated that the assault was meant to be abusive or humiliating. The typical perpetrator of victims' most serious sexual assault experiences was a male enlisted member of the military acting alone. Perpetrators were most often a military peer of the victim; perpetrators who were strangers to the victim were uncommon; and assaults by spouses, significant others, or family members were comparatively rare. Approximately two-thirds of victims' most serious experience of sexual assault occurred at a military installation. The authors found substantial differences by gender, especially in terms of the types of sexual assault behaviors victims experienced and in terms of the setting in which victims were sexually assaulted. The authors also found some evidence suggesting that sexual minorities-that is, individuals who identify with a sexual orientation other than heterosexual-may experience more-violent sexual assaults and more assaults that are meant to abuse, humiliate, haze, or bully, especially among men.","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"10 3 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49512303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Managing Urinary Incontinence for Women in Primary Care: Environmental Scan (Base Year). 管理尿失禁的妇女在初级保健:环境扫描(基准年)。

Rand health quarterly Pub Date : 2023-06-01

Sydne J Newberry, Jeannette Tsuei, Jody Larkin, Aneesa Motala, Kayla Howard, Gena Dunivan

{"title":"Managing Urinary Incontinence for Women in Primary Care: Environmental Scan (Base Year).","authors":"Sydne J Newberry, Jeannette Tsuei, Jody Larkin, Aneesa Motala, Kayla Howard, Gena Dunivan","doi":"","DOIUrl":"","url":null,"abstract":"Urinary incontinence (UI) is a highly prevalent condition among women worldwide. Although effective nonsurgical treatments exist, including pharmacological, behavioral, and physical therapies, many women with the condition are never diagnosed because of a lack of information, stigma, and the absence of regular screening in primary care, and those who are diagnosed might not receive or adhere to treatment. In this study, the authors present an environmental scan of studies published from 2012 through 2022 that assess the dissemination and implementation of nonsurgical UI treatment-including screening, management, and referral strategies-for women in primary care. The scan was conducted as part of the RAND's support and evaluation contract for the Agency for Healthcare Research and Quality's Managing Urinary Incontinence initiative. The initiative, which builds on the agency's EvidenceNOW model, funds five grant projects to disseminate and implement improved nonsurgical treatment of UI for women within primary care practices in separate regions of the United States.","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"10 3","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9662458","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 : 2023-06-01

引用次数: 0

Managing Urinary Incontinence for Women in Primary Care: Environmental Scan (Base Year). 管理尿失禁的妇女在初级保健:环境扫描(基准年)。

Rand health quarterly Pub Date : 2023-06-01 DOI: 10.7249/rra1932-1

S. Newberry, J. Tsuei, Jody Larkin, Aneesa Motala, Kayla Howard, G. Dunivan

引用次数: 0

Environmental Scan on Consolidation Trends and Impacts in Health Care Markets. 医疗保健市场整合趋势和影响的环境扫描。

Rand health quarterly Pub Date : 2023-06-01

Jodi L Liu, Zachary M Levinson, Annetta Zhou, Xiaoxi Zhao, PhuongGiang Nguyen, Nabeel Qureshi

{"title":"Environmental Scan on Consolidation Trends and Impacts in Health Care Markets.","authors":"Jodi L Liu, Zachary M Levinson, Annetta Zhou, Xiaoxi Zhao, PhuongGiang Nguyen, Nabeel Qureshi","doi":"","DOIUrl":"","url":null,"abstract":"The No Surprises Act (NSA) was created to help protect consumers with private insurance from surprise medical bills from out-of-network health care providers. The NSA requires the Department of Health and Human Services to prepare annual reports to Congress on the effects of the NSA's provisions. This article summarizes findings of an environmental scan on consolidation trends and impacts in health care markets. It describes the evidence on price, spending, quality of care, access, and wages in health care provider and insurance markets, as well as other market trends. The authors found strong evidence that hospital horizontal consolidation is associated with higher prices paid to providers and some evidence of the same for vertical consolidation of hospitals and physician practices. Health care spending is likely to increase in tandem with these price increases. Most studies find decreased or no change in quality of care associated with consolidation; however, findings differ by quality measures examined and setting. Horizontal consolidation of commercial insurers is associated with lower prices paid to providers as insurers gain market power in negotiations with providers, but the lower prices paid to providers do not appear to be passed onto consumers, who face higher premiums following insurer consolidation. There is insufficient evidence of the effects on patient access to care and health care wages. The few evaluations of state surprise billing laws have found heterogeneous effects on prices and have not directly examined effects on spending, quality, patient access, and wages.","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"10 3","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9662459","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

Alternative Approaches for Expanding the Air Force's Task Force True North Program. 扩大空军特遣部队真北计划的替代方法。

Rand health quarterly Pub Date : 2023-06-01

Agnes Gereben Schaefer, John A Ausink, Thomas Goughnour, Kristie L Gore, Kimberly Jackson, Paul Emslie

{"title":"Alternative Approaches for Expanding the Air Force's Task Force True North Program.","authors":"Agnes Gereben Schaefer, John A Ausink, Thomas Goughnour, Kristie L Gore, Kimberly Jackson, Paul Emslie","doi":"","DOIUrl":"","url":null,"abstract":"The Air Force seeks to maximize airman fitness and minimize threats to individual and unit readiness, such as domestic and sexual violence and suicide. The purpose of the Air Force's Task Force True North (TFTN) is to provide effective prevention and treatment programs to airmen in need by embedding health care providers directly into units. In this study, the authors identify potential courses of action (COAs) for expanding the TFTN program, including estimating each approach's associated manpower requirements, recruiting requirements, total costs, and implementation timelines. In developing these COAs, the authors analyzed embedded behavioral and physical health programs in the Army, Navy, Marine Corps, and U.S. Special Operations Command; developed a framework for analyzing mental, physical, and social squadron risk levels; developed personnel packages for low-, medium-, and high-risk squadrons; and estimated the costs of implementing these personnel packages under different timelines. In addition to detailing these COAs, the authors provide recommendations on best practices for the Air Force to follow as it expands the TFTN program.","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"10 3","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10036450","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

Policy Decisionmaking in Long-Term Care: Lessons from Infection Control During the COVID-19 Pandemic. 长期护理的政策决策：新冠肺炎大流行期间感染控制的经验教训。

Rand health quarterly Pub Date : 2023-06-01 DOI: 10.7249/rra2128-1

L. Frank, T. Concannon, Jordan M. Harrison, Sarah Zelazny

{"title":"Policy Decisionmaking in Long-Term Care: Lessons from Infection Control During the COVID-19 Pandemic.","authors":"L. Frank, T. Concannon, Jordan M. Harrison, Sarah Zelazny","doi":"10.7249/rra2128-1","DOIUrl":"https://doi.org/10.7249/rra2128-1","url":null,"abstract":"The COVID-19 pandemic focused attention on long-term care facilities' need for infection-control policies that balanced community safety and individual well-being. Infection-control policies were often developed, implemented, and mandated without the input or involvement of those who are most affected: residents and their family members, administrators, and staff. This failure led to declines in residents' physical and mental health. The pandemic exposed an opportunity-and an imperative-to reimagine long-term care in a way that is centered on the needs and preferences of those who receive care, their family members, and those who provide care. This study lays the groundwork for cultural change and a move toward inclusive policy decisionmaking in long-term care through a review of infection-control policy decisions and action items proposed in guided discussions with a diversity of stakeholders-long-term care residents, direct care staff, and consumer advocates to facility administrators, clinicians, researchers, and industry organizations. Transforming the culture of long-term care to elevate the needs of residents will require attention to facility leadership, along with steps to increase inclusiveness, transparency, and accountability in decisionmaking.","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"10 3 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44617116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0