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.

Reassessing the marijuana gateway effect

Abstract: Aims. Strong associations between marijuana use and initiation of hard drugs are cited in support of the claim that marijuana use per se increases youths' risk of initiating hard drugs (the "marijuana gateway" effect). This report examines whether these associations could instead be explained as the result of a common factor, drug use propensity, influencing the probability of both marijuana and other drug use. Design. A model of adolescent drug use initiation in the United States is constructed using parameter estimates derived from U.S. household surveys of drug use conducted between 1982 and 1994. Model assumptions include: 1) individuals have a nonspecific random propensity to use drugs that is normally distributed in the population; 2) this propensity is correlated with the risk of having an opportunity to use drugs and with the probability of using them given an opportunity; and 3) neither use nor opportunity to use marijuana is associated with hard drug initiation after conditioning on drug use propensity. Findings. Each of the phenomena used to support claims of a

Evidence About The Link Between Education, Poverty and Terrorism Among Palestinians

Abstract: The primary goal of this paper is to investigate whether participation in terrorist activity can be linked to ignorance (measured through schooling) or to economic desperation (measured through poverty on the individual's level and various economic indicators on the societal level) using newly culled data of Hamas and Palestinian Islamic Jihad (PIJ) terrorist cells. This paper performs a statistical analysis of the determinants of participation in Hamas and PIJ terrorist activities in Israel from the late 1980's to the present, as well as a time series analysis of terrorist attacks in Israel with relation to economic conditions. The resulting evidence on the individual level suggests that both higher standards of living and higher levels of education are positively associated with participation in Hamas or PIJ. With regard to the societal economic condition, no sustainable link between terrorism and poverty and education could be found, which I interpret to mean that there is either no link or a very weak indirect link. Special attention is given to the suicide-bomber phenomenon, and the analysis of the determinants of becoming a suicide-bomber provides additional intriguing findings. In contrast with the "classic" characteristics of a suicidal individual (Hamermesh and Soss, 1974), suicide-bombers tend to be of higher economic status and higher educational attainment than their counterparts in the population.

Health care for black and poor hospitalized Medicare patients.

Abstract: Objective. —To analyze whether elderly patients who are black or from poor neighborhoods receive worse hospital care than other patients, taking account of hospital effects and using validated measures of quality of care. Design. —We compare quality of care provided to insured, hospitalized Medicare patients who are black or live in poor neighborhoods as compared with others, using simple and multivariable comparisons of clinically detailed measures of sickness at admission, quality, and outcomes. Setting. —Two hundred ninety-seven acute care hospitals in 30 areas within five states. Patients or Other Participants. —The sample includes a nationally representative sample of 9932 patients 65 years of age or older who lived at home prior to hospitalization for congestive heart failure, acute myocardial infarction, pneumonia, or stroke. Interventions. —This was an observational study. Main Outcome Measures. —Processes of care, length of stay, instability at discharge, discharge destination, and mortality. Results. —Within rural, urban nonteaching, and urban teaching hospitals, patients who are black or from poor neighborhoods have worse processes of care and greater instability at discharge than other patients (P Conclusions. —Quality of hospital care for insured Medicare patients is influenced both by the patient's race and financial characteristics and by the hospital type in which the patient receives care. (JAMA. 1994;271:1169-1174)

Effects of Survey Mode, Patient Mix, and Nonresponse on CAHPS® Hospital Survey Scores

Abstract: Objective To evaluate the need for survey mode adjustments to hospital care evaluations by discharged inpatients and develop the appropriate adjustments.