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.

Profiles of Older Medicare Decedents

Abstract: OBJECTIVES: To evaluate the usefulness of a clinical scheme to classify older decedents to better understand the issues associated with healthcare use and costs in the last year of life. DESIGN: We analyzed Medicare claims data for a random sample of 0.1% of all Medicare beneficiaries with expenditures between 1993 and 1998. This sample yielded 7,966 deaths. SETTING: Medicare claims data. PARTICIPANTS: Medicare beneficiaries. MEASUREMENTS: We classified decedents into groups representing four trajectories at the end of life: sudden death, terminal illness, organ failure, and frailty. RESULTS: Ninety-two percent of decedents were captured by the profiling strategy. The four trajectory groups had distinct patterns of demographics, care delivery, and Medicare expenditures. Frailty was a dominant pattern, with 47% of all decedents, whereas sudden death claimed only 7%; cancer claimed 22%, and organ system failure, 16%. CONCLUSIONS: The clinical scheme to classify decedents appears to fit most decedents and to form groups with substantial clinical differences. Acknowledging the differences among these groups may be a fruitful way to evaluate expenditures and develop strategies to improve care at the end of life.

The Clementine Mission to the Moon: Scientific Overview

Abstract: In the course of 71 days in lunar orbit, from 19 February to 3 May 1994, the Clementine spacecraft acquired just under two million digital images of the moon at visible and infrared wavelengths. These data are enabling the global mapping of the rock types of the lunar crust and the first detailed investigation of the geology of the lunar polar regions and the lunar far side. In addition, laser-ranging measurements provided the first view of the global topographic figure of the moon. The topography of many ancient impact basins has been measured, and a global map of the thickness of the lunar crust has been derived from the topography and gravity.

Coup-proofing: Its Practice and Consequences in the Middle East

Abstract: In the aftermath of the U.S.-led coalition’s defeat of Iraq in the Gulf War, many observers believed that Saddam Hussein would eventually be toppled in a military coup. After years of dashed hopes, however, few expect that the Iraqi military is likely to undertake such action. Many analysts claim that the Iraqi regime is, in fact, coup-proof. Saddam Hussein’s staying power should cause any similarly led U.S. coalition to rethink not just the possibilities of both coups and coupprooang but how it would aght and defeat a coup-proof regime. In this article, I analyze how states become coup-proof, focusing speciacally on the policies that Saudi Arabia, Iraq, and Syria have adopted to achieve this goal. These policies include reliance on groups with special loyalties to the regime and the creation of parallel military organizations and multiple internal security agencies. The United States has a particular interest in how these countries have made their regimes coup-proof. Saudi Arabia is an important U.S. ally, Iraq is a hostile state, and Syria is somewhere in between. Conoict between the United States and either Iraq or Syria, however, pits a superpower with a short attention span against regimes that have accepted serious constraints on their ability to exercise their full military potential. Both states have developed heavily politicized militaries that are incapable of realizing this potential as long as their leaderships continue to divert resources to protect their regimes. At the same time, they have created a militarized politics that is surprisingly resilient in the face of defeat. If a U.S-led coalition decides that it wants to overthrow a coup-proofed regime through military action, it will have to devote serious attention to the regime’s true underpinnings. Field commanders will need more extensive means of understanding their opponent’s political-military situation and greater insight into the coalition’s political intentions. Moreover, the coordination of political-military operations will require greater political involvement