on Facebook
on Twitter
on YouTube
Current Project Highlights
Medical Readiness and Deployment-Related Health Issues
Evaluating DoD's psychological health and traumatic brain injury programs
The recent increase in operational tempo and prolonged nature of the conflicts in Iraq and Afghanistan come with a number of challenges for service members and their families. Some will suffer psychological health (PH) problems including post-traumatic stress disorder, depression or anxiety disorders. At the same, time there is growing concern about the incidence of traumatic brain injury (TBI) among service personnel. Over the past several years, the Department of Defense (DoD) has implemented numerous programs, interventions and other services to address these issues. RAND is conducting a study to identify and evaluate the effectiveness of DoD sponsored programs designed to support PH and TBI among service personnel and their families.
Helping Wounded Warriors
In 1973, the nation moved from a mixed force of conscripts and volunteers to an all-volunteer force. With this transition, the status of combat wounded has changed. During prior wars, the most serious casualties were usually medically discharged and released to care in VA facilities. Today, some comparable combat casualties from Afghanistan and Iraq may be retained on active duty or medically retired with full benefits and treated via the TRICARE system. To help DoD understand the implications of retaining severely injured personnel on active duty, RAND is examining the shift in the management of war wounded by assessing (1) changes in the relevant policies, laws, directives, and funding allocations, along with the collection of statistical information on servicemen and servicewomen moving through the system; (2) health-related and social support needs of severely wounded and retained servicemembers and their spouses; and (3) the process of reintegrating the war wounded into military units.
Psychological Toll of Deployment to Iraq and Afghanistan
In addition to physical injuries, troops are returning from Iraq and Afghanistan with an array of mental and emotional scars, some of which do not manifest themselves until well after the servicemember has returned home. This major study is collecting and analyzing information about the needs of, and services for, military personnel suffering from posttraumatic stress disorder, traumatic brain injury, and other mental and emotional injuries associated with deployment to Iraq or Afghanistan.
Information on Traumatic Brain Injury
Combat troops in today's war zones are at risk for traumatic brain injury (TBI) from the blasts of improvised explosive devices. The physical, psychological, and emotional symptoms of these "silent" war wounds are often misinterpreted and pose a huge challenge to military and medical professionals and to families of affected servicemembers. RAND is analyzing data from focus groups to inform the refinement of informational materials developed by the Defense and Veterans Brain Injury Center for servicemembers with mild TBI and their families.
Occupational Health Program Review
Today's DoD workforce is highly skilled, works under high pressure, and often takes risks to accomplish its national security mission. Despite the workforce's changing jobs and performance tasks, DoD still maintains a decades-old industrial-based approach to military accession, occupational health, and disability evaluation. RAND is conducting a comprehensive review of existing DoD occupational health and wellness programs for the purpose of informing the design of an integrated and comprehensive employee health program for DoD's active duty workforce.
Joint Medical Education and Training
Lessons learned on today's battlefields show that medical personnel and organizations from all U.S. services are blended as required with those of other services, nations, and agencies to provide battlefield medical care. Thus, joint education and training is needed to provide the common groundwork and understanding that allows U.S. service medical personnel to work together effectively in such stressful environments and to be fully trained for roles outside the battlefield, including duties related to homeland defense, civil support, and medical civil-military operations. RAND is assisting the U.S. Army Medical Education and Training Center in developing its joint and service-specific training and curricula and establishing the basis for effective and efficient delivery of the training over time.
Assessing Medical Readiness of the Reserve Components
As an integral part of the U.S. military, the Reserve Components are continually called upon to support operations around the globe. Besides the need to be properly equipped and trained, the Reserve Components must also ensure that servicemembers are medically ready to serve when called upon. RAND is reviewing medical and dental readiness requirements of the Reserve units and assessing the systems used to monitor compliance with standards. When possible, RAND is also identifying the costs of maintaining Reserve Component members at the required level of medical/dental readiness and assessing the costs of alternative approaches to improving readiness that will ensure compliance with Reserve Component standards.
Non-Combat-Related Medical Care
Reviewing the VA Enrollee Health Care Projection Model
The Department of Veterans Affairs relies on the Enrollee Health Care Projection Model to project veteran enrollment, their use of health care services, and the cost of providing those services. These data are used to set the VA medical care budget. RAND is reviewing and assessing the VA Enrollee Health Care Projection Model to determine if its methodology is likely to yield reasonable predictions and to identify potential future modifications to the model.
Health Care for Dual-Eligible TRICARE Beneficiaries
Under current policies, the Centers for Medicare & Medicaid Services, DoD, and VA each view TFL beneficiaries independently. At issue is how to restructure federal funding policies in a way that will foster viewing these dual-eligible beneficiaries as a joint responsibility and will provide them with the highest-quality care at the lowest cost to the federal government. To inform this policy issue, RAND is estimating the costs of care provided to TFL beneficiaries across civilian care, MTFs, and VA facilities and developing potential models for sharing costs between the programs that would provide incentives for coordinated, cost-effective care.
Review of Military Health Benefit Design
DoD health care benefits provided to retired and Reserve personnel have expanded, while beneficiary cost-sharing arrangements for non–active duty personnel and dependents have decreased. To control escalating health care costs associated with this increased demand, DoD has considered restructuring the health care benefits provided to active duty dependents and military retirees and their dependents. RAND is designing a simulation model to assess the implications, for government and beneficiary cost, of potential changes in the military health benefit and is using the model to evaluate a health savings account option.
Terrorism and Preparedness
Military Installation Readiness for Mass Casualty Events
The nation is improving its ability to prepare for and respond to terrorist incidents and other public health emergencies at the federal, state, and local levels. Many of these efforts, however, have not been well integrated across the public and private sectors or across the range of partners in given communities. RAND is helping DoD to improve installation readiness for mass casualty events by creating an evidence-based framework for assessing risks, by defining and identifying capabilities and capacities, and by facilitating coordination among federal, state, and local government agencies and the private sector.
Biosurveillance for Influenza and Other Strategic Health Threats
The accelerating spread of the novel A (H5N1) influenza strain and the threat of an emerging human pandemic have highlighted the importance of a comprehensive U.S. Armed Forces health surveillance architecture. RAND is examining and recommending ways to optimize use of the DoD Serum Repository, particularly for use in biosurveillance for influenza and other health threats. Overseen by the U.S. Army's Center for Health Promotion and Preventive Medicine, the Serum Repository is the largest longitudinal biospecimen repository in the world.
For more information about the center or its research, please contact us
Top