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.

Are Voters Sensitive to Terrorism? Direct Evidence from the Israeli Electorate

Abstract: This paper relies on the variation of terror attacks across time and space as an instrument to identify the causal effects of terrorism on the preferences of the Israeli electorate. We find that the occurrence of a terror attack within three months of the elections is associated with a 1.35 percentage points increase on the local support for the right bloc of political parties out of the two blocs vote. This effect is of a significant political magnitude given the level of terrorism in Israel and the fact that its electorate is closely split between the right and left blocs. Moreover, a terror fatality has important electoral effects beyond the locality where the attack is perpetrated, and their electoral impact is stronger the closer to the elections they occur. Interestingly, the observed political effects are not affected by the identity of the party holding office. These results provide empirical support for the hypothesis that the electorate shows a highly sensitive reaction to terrorism, and substantiate the claim that terror organizations especially target democratic regimes because these regimes are more prone to make territorial concessions.

Demand-Side Management and Energy Efficiency in the United States

Abstract: Between 1989 and 1999, U.S. electric utilities spent $14.7 billion on demand-side management (DSM) programs aimed at encouraging their customers to make investments in energy efficiency. This study relies on panel data on 324 utilities spanning 11 years to estimate the effect of DSM expenditures on retail electricity sales. Our estimates imply that DSM had a much smaller effect on retail electricity sales than do estimates reported by utilities themselves over the same study period.

Preventable Deaths: Who, How Often, and Why?

Abstract: If the quality of care provided by a hospital affects its death rate, then some deaths must be preventable. We have developed a new method to investigate this issue and have reviewed 182 deaths from 12 hospitals (6 high outliers and 6 low outliers for death rate) for three conditions (cerebrovascular accident, pneumonia, or myocardial infarction). The investigators prepared a dictated summary of each patient's hospital course. Then, at least three physicians reviewed each summary and independently judged whether the death could have been prevented. Using a majority rules criterion (at least two of three physicians agreed), we found that 27% of the deaths might have been prevented. Using a unanimity criterion (all three physicians independently agreed), we found a 14% rate of probably preventable deaths. Patients whose deaths were probably preventable were younger (74.7 compared with 78.6 years, P less than 0.05), less often demented (12% compared with 26%, P less than 0.05), and less severely ill (mean Acute Physiology and Chronic Health Evaluation score, 15.6 compared with 21.2; P less than 0.001) than patients whose deaths were nonpreventable. The physicians also listed causes for each probably preventable death; nine reasons encompassed almost all of them. For myocardial infarction, preventable deaths reflected errors in management. For cerebrovascular accident, however, deaths primarily reflected errors in diagnosis. The severity of illness can help a hospital retrospectively identify probably preventable deaths. In the group of patients who died, 42% of those with a low severity of illness had probably preventable deaths as compared to 11% admitted with a high severity of illness. We found that a significant number of hospital deaths might have been prevented. Our findings were based on a new method that needs further testing to substantiate its validity. These findings also need replication before they can be generalized to other hospitals.

Responsiveness to change: an aspect of validity, not a separate dimension

Abstract: Assessment of health-related quality of life is accelerating in naturalistic observational studies, clinical trials, and clinical practice. Some researchers have argued that the ability of a quality of life instrument to detect clinically important changes over time, “responsiveness”, is a distinct psychometric property from the measure's reliability and validity. We discuss the important implications of this argument and counter that responsiveness is actually one indication of a measure's validity.

Applications of the Medical Outcomes Study health-related quality of life measures in HIV/AIDS

Abstract: The leading health status instruments in human immunodeficiency virus (HIV) research are based on the pool of items developed as part of the Medical Outcomes Study (MOS). The measures include the SF-20, MOS-HIV, SF-36, SF-12, SF-56, SF-38 (Patient Reported Status and Experience Survey (PARSE)), SF-21 and HIV Cost and Service Utilization Study (HCSUS) questionnaires. The instrument length ranges from 12 to 56 items, covering two to 11 dimensions. Completion requires from 2 to 14 minutes. Subscales are scored on a 0-100 scale (a higher score indicates better health); physical and mental health or overall summary scores are available for most of the measures. Three of the instruments are available in multiple languages. The instruments have been administered to over 20,000 persons with HIV in descriptive studies and clinical trials and there is substantial evidence for their reliability, construct and predictive validity and responsiveness. In several studies the measures have shown important differences between treatments. Although existing measures do not assess all domains relevant to HIV disease, additional subscales are available from the MOS pool. Some of the subscales may be prone to floor and ceiling effects. However, summary scales that encompass all of the subscales reduce this issue. Selection among MOS measures should be dictated by specific questions, the balance of available time and resources, and practical concerns.