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Showing papers by "RAND Corporation published in 1988"


Book
01 Jan 1988
TL;DR: In this article, two models of procedural justice are presented: Procedural Justice in Law I and Procedural justice in Law II, and the Generality of Procedural Jurisprudence.
Abstract: 1. Introduction.- 2. Early Research in Procedural Justice.- 3. Research Methods in Procedural Justice Research.- 4. Procedural Justice in Law I: Legal Attitudes and Behavior.- 5. Procedural Justice in Law II: Sources and Implications of Procedural Justice Judgments.- 6. The Generality of Procedural Justice.- 7. Procedural Justice in the Political Arena.- 8. Procedural Justice in Organizations.- 9. Conclusions and Hypotheses.- 10. Two Models of Procedural Justice.- References.- Author Index.

5,785 citations



Journal ArticleDOI
TL;DR: In both studies, the E5 scales showed greater response variability and better predicted whether patients intended to return to the same doctor in the future, recommend the doctor to a friend, and comply with the medical regimen.
Abstract: This paper presents the results of two studies that compared methods for measuring patient satisfaction with specific medical encounters. One form used six-point response scales ranging from “very satisfied” to “very dissatisfied” (S6 scale); the other used five-point scales ranging from “excellent”

611 citations


Journal ArticleDOI
TL;DR: A cross-sectional probability survey of 3132 household adults was conducted in two Los Angeles communities in order to examine the relationship between sexual assault and prevalence of 9 major mental disorders as mentioned in this paper.
Abstract: A cross-sectional probability survey of 3132 household adults was conducted in two Los Angeles communities in order to examine the relationship between sexual assault and prevalence of 9 major mental disorders. Diagnoses of mental disorders were compared between those subjects who reported that they have experienced sexual abuse at some time in their lives and those who were not exposed to sexual assault. Disorders assessed include major depression mania schizophrenia alcohol abuse or dependence antisocial personality phobia panic disorder and obsessive-compulsive disorder. Findings revealed that 13.2% of the studied population have been experiencing lifetime sexual assault. Those who were exposed to childhood sexual abuse were more likely than those assaulted in adulthood to report the development of a mental disorder. Lifetime prevalences of affective disorder including major depressive and manic disorders and drug abuse or dependence as well as three anxiety disorders including phobia mania and obsessive-compulsive disorder were significantly higher among assaulted individuals. The risk ratios indicate that the onset of associated disorder after assault was 2.3-4.0 times greater among the assaulted group relative to the nonassaulted ones. However Hispanic ethnic background and education were unrelated to the occurrence of mental disorders following sexual assault.

560 citations


Journal ArticleDOI
TL;DR: The high predictive utility of the screener, in combination with its brevity, suggests that it may be a useful tool for screening for depression in health care settings.
Abstract: A very short (8-item), self-report measure was developed to screen for depressive disorders (major depression and dysthymia) The screener departs from traditional depressive symptom scales in that 1) individual items are differentially weighted and 2) two of the eight items concern diagnostically r

491 citations


Journal ArticleDOI
TL;DR: The appropriateness of carotid endarterectomy was determined in a random sample of 1302 Medicare patients in three geographic areas who had had the procedure in 1981 by a panel of nationally known experts using a modified Delphi technique.
Abstract: Carotid endarterectomy is a commonly performed but controversial procedure. We developed from the literature a list of 864 possible reasons for performing carotid endarterectomy, and asked a panel of nationally known experts to rate the appropriateness of each indication using a modified Delphi technique. On the basis of the panel's ratings, we determined the appropriateness of carotid endarterectomy in a random sample of 1302 Medicare patients in three geographic areas who had had the procedure in 1981. Thirty-five percent of the patients in our sample had carotid endarterectomy for appropriate reasons, 32 percent for equivocal reasons, and 32 percent for inappropriate reasons. Of the patients having inappropriate surgery, 48 percent had less than 50 percent stenosis of the carotid artery that was operated on. Fifty-four percent of all the procedures were performed in patients without transient ischemic attacks in the carotid distribution. Of these procedures, 18 percent were judged appropriate, as compared with 55 percent judged appropriate in patients with transient ischemic attacks in the carotid distribution. After carotid endarterectomy, 9.8 percent of patients had a major complication (stroke with residual deficit at the time of hospital discharge or death within 30 days of surgery). We conclude that carotid endarterectomy was substantially overused in the three geographic areas we studied. Furthermore, in situations in which the complication rate is equal to or above the study's aggregate rate, carotid endarterectomy would not be warranted, even in cases with an appropriate indication, because the risks would almost certainly outweigh the benefits.

421 citations


Journal ArticleDOI
TL;DR: It is found that hospitals in more competitive markets have lowered their costs significantly, compared with previous studies of hospital competition, which have found that greater competition leads to higher hospital costs.

307 citations


Journal ArticleDOI
TL;DR: A new method based on a new method found that a significant number of hospital deaths might have been prevented, and patients whose deaths were probably preventable were younger, less often demented, and less severely ill than patients whose died.
Abstract: If the quality of care provided by a hospital affects its death rate, then some deaths must be preventable. We have developed a new method to investigate this issue and have reviewed 182 deaths from 12 hospitals (6 high outliers and 6 low outliers for death rate) for three conditions (cerebrovascular accident, pneumonia, or myocardial infarction). The investigators prepared a dictated summary of each patient's hospital course. Then, at least three physicians reviewed each summary and independently judged whether the death could have been prevented. Using a majority rules criterion (at least two of three physicians agreed), we found that 27% of the deaths might have been prevented. Using a unanimity criterion (all three physicians independently agreed), we found a 14% rate of probably preventable deaths. Patients whose deaths were probably preventable were younger (74.7 compared with 78.6 years, P less than 0.05), less often demented (12% compared with 26%, P less than 0.05), and less severely ill (mean Acute Physiology and Chronic Health Evaluation score, 15.6 compared with 21.2; P less than 0.001) than patients whose deaths were nonpreventable. The physicians also listed causes for each probably preventable death; nine reasons encompassed almost all of them. For myocardial infarction, preventable deaths reflected errors in management. For cerebrovascular accident, however, deaths primarily reflected errors in diagnosis. The severity of illness can help a hospital retrospectively identify probably preventable deaths. In the group of patients who died, 42% of those with a low severity of illness had probably preventable deaths as compared to 11% admitted with a high severity of illness. We found that a significant number of hospital deaths might have been prevented. Our findings were based on a new method that needs further testing to substantiate its validity. These findings also need replication before they can be generalized to other hospitals.

270 citations


Journal ArticleDOI
TL;DR: To increase the feasibility of identifying persons with depressive disorders in a large-scale health policy study, the concordance between face-to-face and telephone-administered versions of the depression section of the NIMH Diagnostic Interview Schedule (DIS) was tested.

239 citations


Journal ArticleDOI
TL;DR: A meta-analysis indicated that these asymmetry effects are reliable across a variety of experimental contexts, and hypothesized that the asymmetry effect was caused by an asymmetric prodefendant standard of proof--the reasonable-doubt standard.
Abstract: Investigators have frequently noted a leniency bias in mock jury research, in which deliberation appears to induce greater leniency in criminal mock jurors. One manifestation of this bias, the asymmetry effect, suggests that proacquittal factions are more influential than proconviction factions of comparable size. A meta-analysis indicated that these asymmetry effects are reliable across a variety of experimental contexts. Experiment 1 examined the possibility that the leniency bias is restricted to the typical college-student subject population. The decisions of college-student and community mock jurors in groups beginning deliberation with equal faction sizes (viz., 2:2) were compared. The magnitude of the asymmetry effect did not differ between the two populations. We hypothesized that the asymmetry effect was caused by an asymmetric prodefendant standard of proof--the reasonable-doubt standard. In Experiment 2, subjects received either reasonable-doubt or preponderance-of-evidence instructions. After providing initial verdict preferences, some subjects deliberated in groups composed with an initial 2:2 split, whereas other subjects privately generated arguments for each verdict option. A significant asymmetry was found for groups in the reasonable-doubt condition, but group verdicts were symmetrical under the preponderance-of-evidence instructions. Shifts toward leniency in individual verdict preferences occurred for group members, but not for subjects who performed the argument-generation task. The theoretical and applied significance of these findings is discussed.

239 citations


Journal ArticleDOI
TL;DR: Analysis of claims data from the RAND Insurance Experiment complements analyses of annual medical spending by revealing more about how decisions to spend are made within the year.

Posted Content
TL;DR: In this paper, the authors find empirically whether husbands and wives tend to retire at the same time, and to give an explanation of the findings, concluding that very little of the coordination is due to economic variables, and simple cross-tabulations rule out assortative mating as an important explanation.
Abstract: The objective of the paper is to find empirically whether husbands and wives tend to retire at the same time, and to give an explanation of the findings. Similarity of retirement dates could be caused by similarity of tastes (assortative mating), by economic variables, or by the complimentarity of leisure. Each explanation would have different implications for the response of retirement to policy changes. Both simple data analysis and economic models of the age of retirement point to coordination of retirement dates: husbands and wives tend to retire at the same time. According to the results, very little of the coordination is due to economic variables, and simple cross-tabulations rule out assortative mating as an important explanation. This leaves complimentarity of leisure. Because of data limitations, this conclusion is, however, mainly qualitative. The data set is the Mew Beneficiary Survey.

Journal ArticleDOI
TL;DR: It is found that outpatient mental health use is more responsive to price than is outpatient medical use, but not as responsive as most observational studies have indicated.

Journal ArticleDOI
TL;DR: It is concluded that use of computer support for cooperative work results in both quantitative and qualitative changes but that effective participation in such electronically supported groups requires significant investments of time and energy on the part of its members to master the technology and a relatively high level of assistance during the learning process.
Abstract: It is frequently suggested that work groups that have computer technology to support activities such as text editing, data manipulation, and communication develop systematically different structures and working processes from groups that rely on more conventional technologies such as memos, phone calls, and meetings. However, cross-sectional or retrospective research designs do not allow this hypothesis to be tested with much power. This field experiment created two task forces, each composed equally of recently retired employees and employees still at work but eligible to retire. They were given the identical tasks of preparing reports for their company on retirement planning issues, but they were randomly assigned to different technology conditions. One group had full conventional office support; the other had, in addition, networked microcomputers with electronic mail and routine office software. Structured interviews were conducted four times during the year-long project; in addition, electronic mail activity was logged in the on-line group. Although both groups produced effective reports, the two differed significantly in the kind of work they produced, the group structures that emerged, and evaluations of their own performance. Although the standard group was largely dominated by the employees through the extensive reliance on informal meetings, the electronic technology used by the other task force allowed the retirees to exercise primary leverage. We conclude that use of computer support for cooperative work results in both quantitative and qualitative changes but that effective participation in such electronically supported groups requires significant investments of time and energy on the part of its members to master the technology and a relatively high level of assistance during the learning process.

Journal ArticleDOI
TL;DR: The fact that successful dissemination will not necessarily produce change also has implications for how information transfer programs should be monitored and evaluated.
Abstract: Programs that disseminate information to health care practitioners often do so partly to encourage appropriate changes in practice. However, merely providing information is seldom enough to accomplish such changes. If information transfer programs are to influence practice, they must be designed to maximize the conditions facilitating change. Reliance on a diffusion model for thinking about how information reaches practitioners has led researchers to over-emphasize the importance of exposure to information and ignore other factors that determine whether change will occur, such as practitioners' motivation to change, the context in which clinical decisions are made, and how information is presented. The fact that successful dissemination will not necessarily produce change also has implications for how information transfer programs should be monitored and evaluated.

Journal ArticleDOI
TL;DR: Two panels of doctors were asked to indicate how appropriate they judged a series of possible indications for coronary angiography and coronary artery bypass graft (CABG) operations, and although the two panels tended to rate the appropriateness of the indications in the same order, the UK panel placed more emphasis than did the US panel on the importance of symptoms and the amount of medical treatment.

Journal ArticleDOI
TL;DR: Assault was more common among mental health service users than nonusers, and among women using medical services compared to female nonpatients, which underscores the need for providers to recognize and treat sexual assault-related problems.
Abstract: A history of sexual assault may be associated with increased current use of mental health and medical services because of the psychologically and physically disruptive consequences of assault. To test this hypothesis, we estimated rates of mental health and medical services use among 2560 randomly selected community residents, 343 of whom had been sexually assaulted. Sexual assault was associated with seeking both forms of care. Controls for demographic variables, psychiatric diagnosis, health status, and insurance suggested that assault increases use indirectly, through poor mental and physical health. Uninsured, assaulted respondents were especially likely to consult medical providers. Respondents assaulted during childhood were particularly likely to seek mental health care. Assault was more common among mental health service users than nonusers, and among women using medical services compared to female nonpatients. The high prevalence of assault among service users underscores the need for providers to recognize and treat sexual assault-related problems. Language: en

Journal ArticleDOI
TL;DR: In this article, a sample of homeless adults in the inner-city area of Los Angeles resulted in a sampling design that meets the criteria of the Rossi et al., 1987 study.
Abstract: Recent efforts on the part of survey researchers to understand the characteristics and needs of homeless individuals have been hampered by factors which make it extra ordinarily difficult to draw representative samples of this population. To date, only one study (Rossi et al., 1987) has drawn a probability sample of homeless persons that includes unsheltered individuals. Because the design of the Rossi study can only accommodate a short interview and is best carried out in one night, additional designs that allow more lengthy interview protocols and data collection periods are needed. An effort to draw a probability sample of homeless adults in the inner-city area of Los Angeles resulted in a sampling design that meets these criteria. This article describes this design in detail.

Journal ArticleDOI
TL;DR: The results show that need for care, presence of substitutes for the mother, financial resources, and preferences all affect both full-time care by the mother and the type of child care chosen by working women, although they affect these two decisions in different ways.
Abstract: Because of the high rates of employment of mothers, a large and increasing number of preschool children receive regular care from someone else. This article develops and tests hypotheses about the choice of child care arrangements for younger and older preschool children, using data from the National Longitudinal Survey of Young Women. We argue that appropriate care depends on the age of the child. It includes care by the mother or a paid provider in the child’s home for children aged 0–2 and mother care and nursery school or center care for those 3–5. We estimate models of the mother’s employment and choice of child care separately for younger and older preschoolers. Our results show that need for care, presence of substitutes for the mother, financial resources, and preferences all affect both full-time care by the mother and the type of child care chosen by working women, although they affect these two decisions in different ways.

Journal ArticleDOI
TL;DR: The more life events experienced, the more likely one is to use mental health services, chronic types of life events are more important than acute events in predicting use of mental health Services, and neither social contacts nor social resources buffer the impact of life stress events on use of services.

Patent
26 Jan 1988
TL;DR: In this article, the magnetic properties of a randomly varying and detectable magnetic region are used for verifying an object's authenticity by saturating the magnetizable magnetic regions of the object with water.
Abstract: Apparatus and methods of verifying objects utilize an inherent randomly varying and detectable characteristics of a plurality of spaced apart, magnetizable magnetic regions affixed to the object. Detectability of the randomly varying magnetic characteristics can be enhanced by saturating the magnetic regions. A verification apparatus senses the randomly varying magnetic characteristics and compares it to a prestored representative profile previously created. Correspondence between the prestored profile and the currently read characteristics indicates an authentic object. Other objects can be rejected.

Journal Article
TL;DR: Findings from a retrospective survey of infants born to a probability sample of 1,262 women in peninsular Malaysia confirm the pernicious synergistic effect of poor sanitation and nonbreastfeeding that was postulated previously on theoretical grounds.
Abstract: If they lived in households without piped water or a toilet, Malaysian infants who did not breast-feed were five times more likely to die after 1 week of age than those who breast-fed, when other significant factors affecting infant mortality were taken into account. This is double the relative risk associated with not breast-feeding for infants born into households with toilets, whether or not they had piped water. Analogously, improvements in toilet sanitation appear to have reduced mortality twice as much among infants who did not breast-feed as among those who did. These findings, from a retrospective survey of infants born to a probability sample of 1,262 women in peninsular Malaysia, confirm the pernicious synergistic effect of poor sanitation and nonbreastfeeding that was postulated previously on theoretical grounds. Promoting and maintaining high initiation of breast-feeding is thus particularly important where poor sanitation is prevalent. Even more affluent areas should not be neglected, however, because socioeconomic improvement, including improved environmental sanitation, is often accompanied by decreased breast-feeding. Although the risk to each nonbreast-fed infant was less in those areas, infants there were less likely to breast-feed in Malaysia, and hence they made up a significant proportion of lives that could be saved by breast-feeding.

Journal ArticleDOI
TL;DR: This analysis of practice patterns among study sites provides the clinical basis for understanding the use of upper gastrointestinal endoscopy.
Abstract: Study Objective:To determine how appropriately physicians in 1981 did upper gastrointestinal endoscopy in a randomly selected, community-based sample of Medicare patients. Design:We develo...

Proceedings ArticleDOI
01 Jan 1988
TL;DR: These findings support Kling and Scacchi's (1982) view that any interactive technology introduced into a work group will be more like a “web” than like a discrete entity.
Abstract: What happens when task groups attempt to couple the advantages of online text preparation or data analysis and decision support with computer-based communication capabilities? How, if at all, does networked information technology affect group structures and interaction processes? And do positive answers to these questions depend on having a technology rich environment with computer-sophisticated individuals to start with, or could almost anyone reap significant advantages if provided with basic computer and communications technology?For the last several years, RAND's Institute for Research on Interactive Systems has been pursuing research about the ways electronic information media may influence work groups—their structures, patterns of individual interaction, experiences of task and social involvement.1 Among the questions that have recurred are the following.When work groups get access to computer-based media for handling information and communication tasks, do their structures change? Do they move closer to or further from formally established organizational structures? Do group positions (e.g., leader roles, assistant roles) stay the same or change?Do computer-supported groups overcome physical barriers to interaction (e.g., space or time constraints)? Do they overcome pre-existing social barriers (e.g., status differences)? Do they form tight clusters (“electronic islands”) or are they overlapping and not sharply defined (“loose bundles”)?How if at all do networked information technologies affect the amount or density of interaction in a group? How do they affect extent of members' integration within a group? Or centralization? Or communication across groups?How do these new technologies affect social communication among group members? How do they affect experienced task involvement? Do these media tend to “diffuse,” to spread and include other users and other uses? Do these media supplant or supplement other means for exchanging information and coordinating group tasks?Our research to date has focused largely on the work group as the critical unit of analysis, and on the overall context in which such units are embedded. Our findings support Kling and Scacchi's (1982) view that any interactive technology introduced into a work group will be more like a “web” than like a discrete entity. When a web of interactive technology is introduced into a work group, the sociotechnical system is altered; work groups increasingly become “directly dependent on their material means and resources for their output” (Trist, 1981; cf. Taylor, 1987; Bikson and Eveland, 1986; Johnson and Rice, 1987; Pava, 1983). That is to say, individuals become interdependent not only on one another but also on the technology for accomplishing their tasks; access to and control over the “means of production” assume greater importance. While the avenues for group work and the means for managing it may have multiplied, new challenges are introduced along with the technology that pre-existing social structures may be ill-prepared to handle. New patterns are likely to emerge.Our previous studies of effects of electronic communication (Eveland and Bikson, 1987) allowed us to control type of communications hardware and software as well as its relationship to other computer-based tools; but it did not permit us to evaluate the extent to which network structures and interaction patterns that emerged over time were influenced by the new technology in comparison to ongoing social relationships, task differences, and other factors. It could not reveal how, if at all, computer-supported work group structures and processes differed from those that would be observed in groups employing standard interaction media.We decided, then, that getting at our basic research questions required a field experiment— a procedure that would allow us randomly to assign group members to computer-based vs. traditional support in the completion of identical work goals as well as to design and control the introduction of new information and communications technology. An effective design, it seemed to us, should also have the following characteristics:If individuals are expected to become familiar with new information technology, accomplish a meaningful goal, and in the process have an opportunity to form or reform work structures and social relations, it would require an intervention of about a year's time.Further, if individuals in both the “electronic” and “standard” conditions were to participate in a year-long effort, a strong mission focus was essential—the goal for group activity and the role of communication would have to be highly motivating.Also, for non-collocated individuals to agree to take part (and to continue their participation) in randomly assigned groups, they should be selected from a common “community”; that is; they should come from a common culture, share some concerns, and have some reason to think they might want to work with one another (cf. Markus, 1987).2

Journal ArticleDOI
TL;DR: For a wide variety of payoff functions, this article showed that the expected log optimal portfolio is also game theoretically optimal in a single play or in multiple plays of the stock market, and that there is no essential conflict between good short-term and long-run performance.
Abstract: We show, for a wide variety of payoff functions, that the expected log optimal portfolio is also game theoretically optimal in a single play or in multiple plays of the stock market. Thus there is no essential conflict between good short-term and long-run performance. Both are achieved by maximizing the conditional expected log return.

Journal ArticleDOI
TL;DR: If one considers all patients covered by Medicare, length of stay rose between 1981 and 1984, although the 1985 value was below the 1981 value.


Book
01 Dec 1988
TL;DR: Connection management functions are intimately involved in protocol reliability, and if not designed properly may result in deadlocks or old data eing erroneously delivered in place of current data.

Journal ArticleDOI
TL;DR: Responses' reports on their own disciplinary problems in school and on their class-cutting and absenteeism showed that problem behavior was related to the teenagers' willingness to consider nonmarital childbearing, and the respondents' educational expectations were used as proxy measures of the potential opportunity costs of single parenthood.
Abstract: Data from the US High School and Beyond panel study indicate that of 13061 female high school sophomores who responded to both the baseline questionnaire in 1980 and a 1982 follow-up 41% of blacks 29% of Hispanics and 23% of non-Hispanic whites said they either would or might consider having a child outside of marriage Such willingness was higher among young women who according to their background characteristics were at greater risk of teenage parenthood In addition young black women were more willing to consider having a child while single than were white or Hispanic respondents at every level of risk The data also show that with the possible exception of Hispanics willing respondents generally registered much higher rates of nonmarital childbearing over the 2 years following the baseline survey than the young women unwilling to consider nonmarital childbearing Respondents reports on their own disciplinary problems in school and on their class-cutting and absenteeism showed that such problem behavior was related to the teenagers willingness to consider nonmarital childbearing Proportionally more of the respondents who ranked high on a scale of problem behavior were willing to do so even when background differences were controlled for In addition when the respondents educational expectations were used as proxy measures of the potential opportunity costs of single parenthood the results revealed that the higher their educational expectations the lower their willingness to have an out-of-wedlock birth This pattern persisted when the young womens background risk of teenage childbearing was considered Finally at least among Hispanic and white respondents inidividuals who reported several instances of depression in the previous month were more likely to claim that they would consider nonmarital childbearing than were their nondepressed peers (authors)

Journal ArticleDOI
23 Dec 1988-JAMA
TL;DR: This report document and justify some of the design decisions made to assess the impact of the diagnosis related group (DRG)-based prospective payment system (PPS) on the quality of care for hospitalized Medicare patients.
Abstract: DATA about whether patients live or die following short-term—care hospitalization can serve at least two purposes: (1) to determine if hospital performance has improved or deteriorated over time and (2) to determine if performance differs across hospitals at one given time. Hospital mortality figures have been used in this manner primarily because such data are readily available, easy to understand, and potentially important to the public. However, if mortality data are to be used for these purposes, they must reflect actual differences in the quality of care, not other factors, such as patient sickness at admission. We have been studying hospital mortality and other outcomes as part of a clinically detailed national study to assess the impact of the diagnosis related group (DRG)-based prospective payment system (PPS) on the quality of care for hospitalized Medicare patients. In this report we document and justify some of the design decisions we made