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: Population & Health care. The organization has 9602 authors who have published 18570 publications receiving 744658 citations.

An overview of generic health-related quality of life measures for HIV research.

Abstract: This paper provides a selective review of instruments currently being employed to evaluate generic health-related quality of life in studies of persons with human immunodeficiency virus (HIV). Instruments examined include the Quality of Well-Being Scale, the HIV Overview of Problems/Evaluation System, the COOP Charts, and six Medical Outcomes Study-based measures: the SF-20, SF-30, AIDS-HAQ, SF-36, SF-38 and SF-56. Relative strengths and weaknesses of the measures are discussed.

Racial/ethnic differences in patients' perceptions of inpatient care using the HCAHPS survey.

Abstract: Using HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems, also known as the CAHPS Hospital Survey) data from 2,684 hospitals, the authors compare the experiences of Hispanic, African American, Asian/Pacific Islander, American Indian/Alaska Native, and multiracial inpatients with those of non-Hispanic White inpatients to understand the roles of between- and within-hospital differences in patients' perspectives of hospital care. The study finds that, on average, non-Hispanic White inpatients receive care at hospitals that provide better experiences for all patients than the hospitals more often used by minority patients. Within hospitals, patient experiences are more similar by race/ethnicity, though some disparities do exist, especially for Asians. This research suggests that targeting hospitals that serve predominantly minority patients, improving the access of minority patients to better hospitals, and targeting the experiences of Asians within hospitals may be promising means of reducing disparities in patient experience.

Boosted Regression (Boosting): An Introductory Tutorial and a Stata Plugin:

Abstract: Boosting, or boosted regression, is a recent data-mining technique that has shown considerable success in predictive accuracy. This article gives an overview of boosting and introduces a new Stata ...

Physician Cost Profiling — Reliability and Risk of Misclassification

Abstract: BACKGROUND Insurance products with incentives for patients to choose physicians classified as offering lower-cost care on the basis of cost-profiling tools are increasingly common. However, no rigorous evaluation has been undertaken to determine whether these tools can accurately distinguish higher-cost physicians from lower-cost physicians. METHODS We aggregated claims data for the years 2004 and 2005 from four health plans in Massachusetts. We used commercial software to construct clinically homogeneous episodes of care (e.g., treatment of diabetes, heart attack, or urinary tract infection), assigned each episode to a physician, and created a summary profile of resource use (i.e., cost) for each physician on the basis of all assigned episodes. We estimated the reliability (signal-to-noise ratio) of each physician’s cost-profile score on a scale of 0 to 1, with 0 indicating that all differences in physicians’ cost profiles are due to a lack of precision in the measure (noise) and 1 indicating that all differences are due to real variation in costs of services (signal). We used the reliability results to estimate the proportion of physicians in each specialty whose cost performance would be classified inaccurately in a two-tiered insurance product in which the physicians with cost profiles in the lowest quartile were labeled as “lower cost.” RESULTS Median reliabilities ranged from 0.05 for vascular surgery to 0.79 for gastroenterology and otolaryngology. Overall, 59% of physicians had cost-profile scores with reliabilities of less than 0.70, a commonly used marker of suboptimal reliability. Using our reliability results, we estimated that 22% of physicians would be misclassified in a two-tiered system. CONCLUSIONS Current methods for profiling physicians with respect to costs of services may produce misleading results.

On the Generation of Normal Random Vectors

Abstract: : The simulation of a process may require the use of sampling techniques involving the generation of random vectors from a multivariate normal population with a specified variance-covariance matrix. This is an expository paper which discusses two methods for generating such vectors. (Author)