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.

Expenditures for the care of HIV-infected patients in the era of highly active antiretroviral therapy

Abstract: Background The introduction of expensive but very effective antiviral medications has led to questions about the effects on the total use of resources for the care of patients with human immunodeficiency virus (HIV) infection. We examined expenditures for the care of HIV-infected patients since the introduction of highly active antiretroviral therapy. Methods We interviewed a random sample of 2864 patients who were representative of all American adults receiving care for HIV infection in early 1996, and followed them for up to 36 months. We estimated the average expenditure per patient per month on the basis of self-reported information about care received. Results The mean expenditure was $1,792 per patient per month at base line, but it declined to $1,359 for survivors in 1997, since the increases in pharmaceutical expenditures were smaller than the reductions in hospital costs. Use of highly active antiretroviral therapy was independently associated with a reduction in expenditures. After adjustments f...

Beyond internal consistency reliability: Rationale and user’s guide for Multitrait Analysis Program on the microcomputer

Abstract: A methodology for evaluating Likert-type scales is presented. Multitrait scaling is a straightforward approach to scale analysis that focuses on items as the unit of analysis and utilizes the logic of convergent and discriminant validity. Multitrait scaling is illustrated with the Multitrait Analysis Program, using patient satisfaction data from the Medical Outcomes Study.

Early Predictors of Adolescent Violence

Abstract: Objectives. This study sought to identify early predictors of adolescent violence and to assess whether they vary by sex and across different types and levels of violence. Methods. Data fV'om a 5-year longitudinal self-report survey of more than 4300 high school seniors and dropouts from California and Oregon were used to regress measures of relational, predatory, and overall violence on predictors measured 5 years earlier. Results. Deviant behavior in grade 7, poor grades, and weak bonds with middle school predicted violent behavior 5 years later. Attending a middle school with comparatively high levels of cigarette and marijuana use was also linked with subsequent violence. Early drug use and peer drug use predicted increased levels of predatory violence but not its simple occurrence. Girls with low self-esteern during early adolescence were more likely to hit others later on; boys who attended multiple elementary schools were also more likely to engage in relational violence, Conciusions. Violence prevention programs for younger adolescents should include efforts to prevent or reduce troublesome behavior in school and poor academic performance. Adolescent girls may also profit from efforts to raise self-esteem; adolescent boys may need extra training in resisting influences that encourage deviant behavior. Programs aimed at preventing drug use may yield an added violencereduction bonus, {Am J Public Heaith. 2000;90:566-572) During the last decade, violence has received increasing attention as a major public health issue for Americans of all ages,' Of particular concern is the degree to which violence affects the lives of youth, either as the perpetrators or as the victims of violence. Between 1985 and 1990, arrests for murder, manslaughter, and aggravated assault rose by 60% for children younger than 18 years,^ Between 1985 and 1991, homicide arrest rates actually declined among those older than 25 years, but they doubled among younger males,' These high rates of violence are mirrored by high rates of youth victimization, and violence and victimization tend to have common antecedents,"* Moreover, despite the fact that rates of violent crime have declined across all age groups since 1994, adolescents between the ages of 12 and 19 years remain at highest risk for victimization by violent crime,'

Influence of ambient (outdoor) sources on residential indoor and personal PM2.5 concentrations: analyses of RIOPA data.

Abstract: The Relationship of Indoor, Outdoor and Personal Air (RIOPA) study was designed to investigate residential indoor, outdoor and personal exposures to several classes of air pollutants, including volatile organic compounds, carbonyls and fine particles (PM2.5). Samples were collected from summer, 1999 to spring, 2001 in Houston (TX), Los Angeles (CA) and Elizabeth (NJ). Indoor, outdoor and personal PM2.5 samples were collected at 212 nonsmoking residences, 162 of which were sampled twice. Some homes were chosen due to close proximity to ambient sources of one or more target analytes, while others were farther from sources. Median indoor, outdoor and personal PM2.5 mass concentrations for these three sites were 14.4, 15.5 and 31.4 microg/m3, respectively. The contributions of ambient (outdoor) and nonambient sources to indoor and personal concentrations were quantified using a single compartment box model with measured air exchange rate and a random component superposition (RCS) statistical model. The median contribution of ambient sources to indoor PM2.5 concentrations using the mass balance approach was estimated to be 56% for all study homes (63%, 52% and 33% for California, New Jersey and Texas study homes, respectively). Reasonable variations in model assumptions alter median ambient contributions by less than 20%. The mean of the distribution of ambient contributions across study homes agreed well for the mass balance and RCS models, but the distribution was somewhat broader when calculated using the mass balance model with measured air exchange rates.