Word: rand
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...Wahabi strand of Islam deems them heretics.) But Pakistan's response to Iran will ultimately be determined by the all-powerful military establishment. And, analysts say, the army is a great deal more wary of Iran's regional aspirations. "They are not really allies," says Christine Fair of the RAND Corp. in Washington. "There is a misguided assumption that just because Pakistan gave Iran nuclear technology that they have some kind of strategic alliance." That deal, analysts say, arose out of former army chief General Mirza Aslam Beg's wish to "create problems for the U.S." (See pictures of terrorism...
Those, at least, are the arguments, though it was impossible to know how well-founded they were - until now. In twin studies published this week in the Annals of Internal Medicine, the Rand Corp. reports on an extensive survey of cost, quality and availability of retail health operations, and on nearly all measures, the clinics scored high...
...perhaps the more relevant question is, How good is the care at these stop-and-shop operations? To answer that, the Rand investigators focused on just one state, Minnesota, because clinics are well-established there and because one large health plan has been providing clinic coverage for its members for five years, meaning that there was a rich vein of data to mine. The investigators focused on data on 2,100 patients who had gone to a clinic for one of three common complaints: sore throat, urinary tract infection and earache. These were compared to patients who had visited doctors...
Average cost per lab test in the Rand study also differed significantly depending on the provider: $15 at retail clinics, $27 at urgent-care facilities, $33 at doctors' offices and a whopping $113 at the ER. The study did not bear out the fear that retail clinics would be inclined to overprescribe drugs, and when the clinics did write a prescription, the out-of-pocket cost was lower: $21 compared to a high...
Neither the clinics nor the studies are perfect, as the Rand team concedes. Even an exhaustive survey of one state is still a study of just that state. And the very accessibility of those Minnesota clinics might have encouraged more visits by mildly ill people whose complaints would have vanished on their own. Give the clinics so many easy pitches to hit and you may artificially drive up their average. Still, with local and regional hospitals such as the Cleveland Clinic increasingly working in partnership with such retail operations, more and more of these in-store outlets are likely...