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.

Reducing patients' unmet concerns in primary care: the difference one word can make.

Abstract: Context In primary, acute-care visits, patients frequently present with more than 1 concern. Various visit factors prevent additional concerns from being articulated and addressed.

Premarital Cohabitation and Subsequent Marital Dissolution: A Matter of Self-Selection?"

Abstract: Married couples who began their relationship by cohabiting appear to face an increased risk of marital dissolution, which may be due to self-selection of more dissolution-prone individuals into cohabitation before marriage. This paper uses newly developed econometric methods to explicitly address the endogeneity of cohabitation before marriage in the hazard of marital disruption by allowing the unobserved heterogeneity components to be correlated across the decisions to cohabit and to end a marriage. These methods are applied to data from the National Longitudinal Study of the High School Class of 1972. We find significant heterogeneity in both cohabitation and marriage disruption, and discover evidence of self-selection into cohabitation.

Mental Health Conditions Among Patients Seeking and Undergoing Bariatric Surgery: A Meta-analysis

Abstract: Importance Bariatric surgery is associated with sustained weight loss and improved physical health status for severely obese individuals. Mental health conditions may be common among patients seeking bariatric surgery; however, the prevalence of these conditions and whether they are associated with postoperative outcomes remains unknown. Objective To determine the prevalence of mental health conditions among bariatric surgery candidates and recipients, to evaluate the association between preoperative mental health conditions and health outcomes following bariatric surgery, and to evaluate the association between surgery and the clinical course of mental health conditions. Data Sources We searched PubMed, MEDLINE on OVID, and PsycINFO for studies published between January 1988 and November 2015. Study quality was assessed using an adapted tool for risk of bias; quality of evidence was rated based on GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. Findings We identified 68 publications meeting inclusion criteria: 59 reporting the prevalence of preoperative mental health conditions (65 363 patients) and 27 reporting associations between preoperative mental health conditions and postoperative outcomes (50 182 patients). Among patients seeking and undergoing bariatric surgery, the most common mental health conditions, based on random-effects estimates of prevalence, were depression (19% [95% CI, 14%-25%]) and binge eating disorder (17% [95% CI, 13%-21%]). There was conflicting evidence regarding the association between preoperative mental health conditions and postoperative weight loss. Neither depression nor binge eating disorder was consistently associated with differences in weight outcomes. Bariatric surgery was, however, consistently associated with postoperative decreases in the prevalence of depression (7 studies; 8%-74% decrease) and the severity of depressive symptoms (6 studies; 40%-70% decrease). Conclusions and Relevance Mental health conditions are common among bariatric surgery patients—in particular, depression and binge eating disorder. There is inconsistent evidence regarding the association between preoperative mental health conditions and postoperative weight loss. Moderate-quality evidence supports an association between bariatric surgery and lower rates of depression postoperatively.

The role of perceived team effectiveness in improving chronic illness care

Abstract: Background/Objectives:The importance of teams for improving quality of care has received increased attention. We examine both the correlates of self-assessed or perceived team effectiveness and its consequences for actually making changes to improve care for people with chronic illness.Study Setting