RAND Corporation

About: RAND Corporation is a nonprofit organization based out in Santa Monica, California, United States. It is known for research contribution in the topics: Health care & Population. The organization has 9602 authors who have published 18570 publications receiving 744658 citations.

Prenatal and delivery care and childhood immunization in guatemala: Do family and community matter?

Abstract: In this paper we investigate family choices about pregnancy-related care and the use of childhood immunization. Estimates obtained from a multilevel logistic model indicate that use of formal (or “modern ”) health services differs substantially by ethnicity, by social and economic factors, and by availability of health services. The results also show that family and community membership are very important determinants of the use of health care, even in the presence of controls for a large number of observed characteristics of individuals, families, and communities.

Characterizing Climate-Change Uncertainties for Decision-Makers. An Editorial Essay

Abstract: ROBERT LEMPERT1, NEBOJSA NAKICENOVIC2, DANIEL SAREWITZ3 and MICHAEL SCHLESINGER4 1RAND, Santa Monica, CA 90407, U.S.A. E-mail: lempert@rand.org 2International Institute for Applied Systems Analysis, A-2361 Laxenburg and Vienna University of Technology, A-1040 Vienna, Austria 3Arizona State University, Consortium for Science, Policy, and Outcomes, Tempe AZ, 85287-4501, U.S.A. 4Department of Atmospheric Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, U.S.A.

Use of mental health and substance abuse treatment services among adults with HIV in the United States

Abstract: Background The need for mental health and substance abuse services is great among those with human immunodeficiency virus (HIV), but little information is available on services used by this population or on individual factors associated with access to care. Methods Data are from the HIV Cost and Services Utilization Study, a national probability survey of 2864 HIV-infected adults receiving medical care in the United States in 1996. We estimated 6-month use of services for mental health and substance abuse problems and examined socioeconomic, HIV illness, and regional factors associated with use. Results We estimated that 61.4% of 231 400 adults under care for HIV used mental health or substance abuse services: 1.8% had hospitalizations, 3.4% received residential substance abuse treatment, 26.0% made individual mental health specialty visits, 15.2% had group mental health treatment, 40.3% discussed emotional problems with medical providers, 29.6% took psychotherapeutic medications, 5.6% received outpatient substance abuse treatment, and 12.4% participated in substance abuse self-help groups. Socioeconomic factors commonly associated with poorer access to health services predicted lower likelihood of using mental health outpatient care, but greater likelihood of receiving substance abuse treatment services. Those with less severe HIV illness were less likely to access services. Persons living in the Northeast were more likely to receive services. Conclusions The magnitude of mental health and substance abuse care provided to those with known HIV infection is substantial, and challenges to providers should be recognized. Inequalities in access to care are evident, but differ among general medical, specialty mental health, and substance abuse treatment sectors.