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The Wyden amendment to the National Science Foundation (NSF) Authorization Act of 2002 sought to determine whether federally funded educational programs other than sports comply with Title IX, which prohibits gender discrimination. At the request of NSF, this report analyzes administrative data from fiscal years 2001 through 2003 describing the outcomes of grant applications submitted by women versus men to federal agencies, specifically with regard to the probability of getting funded, the funding requested, the size of the award, and the probability of applying again. The report focuses on three federal agencies: the National Institutes of Health (NIH), NSF, and the U.S. Department of Agriculture. Overall the study finds that few gender differences in federal grant funding exist over the period studied. However, women applying as principal investigators to NIH receive less funding than men do, and overall women are somewhat less likely to apply again to the same agency. In addition to the findings, the authors of the report observe the many limitations in the information collected by federal grant application and award data systems and recommend ways the federal agencies can improve their tracking of gender differences.

Federal aid to research --- Sexism --- Women in science --- Sex differences. --- Research grants

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When Congress directed that Medicare develop a prospective payment system for acute hospital care in 1983, rehabilitation hospitals were exempted. The exemption arose from a concern that the patient classification system and payment approach developed for acute care hospitals would be inappropriate for inpatient rehabilitative care. Rehabilitative care emphasizes the treatment of functional limitation and disabilities, and it usually follows a period of acute or surgical care. In contrast, acute hospital care emphasizes the stabilization of the acute problem. Consequently, one issue concerns the desirability of basing payment for rehabilitative care on diagnosis instead of some measure of functional status. A more fundamental issue is whether a separate payment system for rehabilitation is desirable given that rehabilitation typically follows acute hospital care. A major purpose of this report is to evaluate the hypothesis that functional status, rather than diagnosis, determines the costs of a rehabilitative stay and to identify other sources of differences in costs.

Rehabilitation --- People with disabilities --- Hospitals --- Costs. --- Costs --- Forecasting. --- Functional assessment --- Economic aspects --- Rehabilitation services --- Prospective payment

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This report addresses the question of whether the extensive use of physician extenders--nonphysicians trained to perform some of the medical and administrative tasks traditionally performed by physicians--in Air Force hospitals is cost-effective. Specifically, it examines the productivity of extenders in outpatient care and the costs of procuring and using extenders. The authors focused on one type of extender, physician assistants (PAs), who are typically Air Force corpsmen with one year of classroom and one year of clinical training. The general conclusions were the following: In typical Air Force primary adult medicine clinics, PAs can substitute for physicians one-to-one for 80-90 percent of the patients whose problems lie within the PA's expertise. Relying on PAs to perform most of the primary medicine workload is currently cost-effective, and will remain so until the earnings of civilian physicians decrease markedly relative to the earnings of PAs.

Physicians' assistants --- Nurse practitioners --- Clinics --- Physicians' Assistants. --- Primary health care --- Costs and cost analysis. --- Military medicine --- Employees. --- Manpower --- United States. --- Medical care.

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Preferred provider organizations (PPOs), which offer some of the advantages of both fee-for-service and managed care, are becoming an important market force. This report provides empirical estimates of the effects of offering a PPO option within indemnity plans on use of outpatient mental health services. The data are from a study that examined a sample of employees who had enrolled in indemnity plans before and after a PPO option was offered by three employers in two U.S. sites. The authors found little evidence for either adverse or favorable selection of indemnity enrollees on the basis of their mental health status into use of the PPO option, either for general medical care or for mental health care. After controlling for other factors, the authors found no significant association between mental health status and intent to use PPO providers for general medical care. The pattern of results suggests that established provider relationships, rather than level of mental health status per se, determine selection of provider among users of outpatient mental health care. By the second year following PPO implementation, after controlling for sociodemographic factors and previous use of mental health services, there was no difference in probability of use of outpatient mental health services between employees who expected to use PPO providers and those who did not. But costs per user of mental health services were lower for individuals who relied primarily on PPO rather than non-PPO providers for their mental health care. Thus, despite lower cost sharing for services received from PPO providers, the PPO option appeared to lower outpatient mental health care costs with no more than a transient reduction in access to such care.

Mental health services --- Ambulatory medical care --- Preferred provider organizations (Medical care) --- Mental health insurance. --- Ambulatory Care --- Health Benefit Plans, Employee --- Preferred Provider Organizations --- Utilization --- utilization

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Because Reserve Component (RC) members have been increasingly used in an operational capacity, among the policy issues being addressed by the 11th Quadrennial Review of Military Compensation (QRMC) is compensation and benefits for the National Guard and Reserve. As part of the review, RAND was asked to analyze healthcare coverage and disability benefits for RC members, including participation in the TRICARE Reserve Select (TRS) program, the potential effects of national health reform on coverage rates, and disability evaluation outcomes for RC members. This report summarizes the results of RAND's analysis. The author finds that 30 percent of RC members lack health insurance to cover care for non-service-related conditions. The TRS program offers the option of purchasing health insurance through the military on terms that are superior to typical employer benefits. Although program participation has increased, it remains low and TRS does not appear to be effectively targeting those most likely to be uninsured. TRS premiums are also lower than the premiums for the new options that will be available under health reform and the same as the penalty for not being insured. So health reform is likely to increase TRS enrollment. Finally, previously deployed RC members are referred to the Disability Evaluation System at a much lower rate than Active Component (AC) members, even for deployment-related conditions, but those who are referred receive dispositions (and thus benefits) similar to those for AC members. These findings suggest that the Department of Defense may want to consider ways to better coordinate TRS with other insurance options that will be available to RC members and that the identification of RC members who experience health consequences from deployment leading to disability merits further investigation.

Managed care plans (Medical care) --- Health insurance --- Disability insurance --- Insurance --- Occupational Groups --- Diagnostic Techniques and Procedures --- Diagnosis --- Financing, Organized --- Persons --- Economics --- Analytical, Diagnostic and Therapeutic Techniques and Equipment --- Named Groups --- Health Care Economics and Organizations --- Health Care --- Military Personnel --- Disability Evaluation --- Insurance, Health --- Insurance, Disability --- Military & Naval Science --- Law, Politics & Government --- Military Administration --- Person --- Community Financing --- Grants --- Organized Financing --- Financing, Community --- Grant --- Antemortem Diagnosis --- Diagnoses and Examinations --- Examinations and Diagnoses --- Postmortem Diagnosis --- Antemortem Diagnoses --- Diagnoses --- Diagnoses, Antemortem --- Diagnoses, Postmortem --- Diagnosis, Antemortem --- Diagnosis, Postmortem --- Postmortem Diagnoses --- Disease --- Disability Insurance --- Group Health Insurance --- Health Insurance --- Health Insurance, Voluntary --- Health Insurance, Group --- Insurance, Group Health --- Insurance, Voluntary Health --- Voluntary Health Insurance --- Disability Evaluations --- Evaluation, Disability --- Evaluations, Disability --- Military --- Air Force Personnel --- Armed Forces Personnel --- Army Personnel --- Coast Guard --- Marines --- Navy Personnel --- Sailors --- Soldiers --- Submariners --- Force Personnel, Air --- Personnel, Air Force --- Personnel, Armed Forces --- Personnel, Army --- Personnel, Military --- Personnel, Navy --- Sailor --- Soldier --- Submariner --- Community-Based Distribution --- Contraceptive Distribution --- Delivery of Healthcare --- Dental Care Delivery --- Distribution, Non-Clinical --- Distribution, Nonclinical --- Distributional Activities --- Healthcare --- Healthcare Delivery --- Healthcare Systems --- Non-Clinical Distribution --- Nonclinical Distribution --- Delivery of Dental Care --- Health Care Delivery --- Health Care Systems --- Activities, Distributional --- Activity, Distributional --- Care, Health --- Community Based Distribution --- Community-Based Distributions --- Contraceptive Distributions --- Deliveries, Healthcare --- Delivery, Dental Care --- Delivery, Health Care --- Delivery, Healthcare --- Distribution, Community-Based --- Distribution, Contraceptive --- Distribution, Non Clinical --- Distributional Activity --- Distributions, Community-Based --- Distributions, Contraceptive --- Distributions, Non-Clinical --- Distributions, Nonclinical --- Health Care System --- Healthcare Deliveries --- Healthcare System --- Non Clinical Distribution --- Non-Clinical Distributions --- Nonclinical Distributions --- System, Health Care --- System, Healthcare --- Systems, Health Care --- Systems, Healthcare --- Diagnostic Technics and Procedures --- Technics and Procedures, Diagnostic --- Techniques and Procedures, Diagnostic --- Healthcare Economics and Organizations --- Capital --- Conditions, Economic --- Consumption --- Cost of Living --- Easterlin Hypothesis --- Economic Conditions --- Economic Factors --- Economic Policies --- Economic Policy --- Economics, Home --- Factors, Economic --- Home Economics --- Household Consumption --- Macroeconomic Factors --- Microeconomic Factors --- Policies, Economic --- Policy, Economic --- Production --- Remittances --- Utility Theory --- Consumer Price Index --- Condition, Economic --- Consumer Price Indices --- Consumption, Household --- Economic Condition --- Economic Factor --- Factor, Economic --- Factor, Macroeconomic --- Factor, Microeconomic --- Factors, Macroeconomic --- Factors, Microeconomic --- Household Consumptions --- Hypothesis, Easterlin --- Index, Consumer Price --- Indices, Consumer Price --- Living Cost --- Living Costs --- Remittance --- Theories, Utility --- Theory, Utility --- Utility Theories --- Group, Occupational --- Groups, Occupational --- Occupational Group --- Indemnity --- Insurance Premiums --- Insurance Premium --- Premium, Insurance --- Premiums, Insurance --- diagnosis --- methods --- Eligibility Determination --- Rehabilitation --- Workers' Compensation --- International Classification of Functioning, Disability and Health --- Military Family --- Sensitivity and Specificity --- Occupations --- Military Deployment --- Deployment, Military --- Military Health --- Employee --- Employees --- Personnel --- Worker --- Workers --- United States --- Armed Forces --- Reserves --- Medical care. --- ABŞ --- ABSh --- Ameerika Ühendriigid --- America (Republic) --- Amerika Birlăshmish Shtatlary --- Amerika Birlăşmi Ştatları --- Amerika Birlăşmiş Ştatları --- Amerika ka Kelenyalen Jamanaw --- Amerika Qūrama Shtattary --- Amerika Qŭshma Shtatlari --- Amerika Qushma Shtattary --- Amerika (Republic) --- Amerikai Egyesült Államok --- Amerikanʹ Veĭtʹsėndi︠a︡vks Shtattnė --- Amerikări Pĕrleshu̇llĕ Shtatsem --- Amerikas Forenede Stater --- Amerikayi Miatsʻyal Nahangner --- Ameriketako Estatu Batuak --- Amirika Carékat --- AQSh --- Ar. ha-B. --- Arhab --- Artsot ha-Berit --- Artzois Ha'bris --- Bí-kok --- Ē.P.A. --- EE.UU. --- Egyesült Államok --- ĒPA --- Estados Unidos --- Estados Unidos da América do Norte --- Estados Unidos de América --- Estaos Xuníos --- Estaos Xuníos d'América --- Estatos Unitos --- Estatos Unitos d'America --- Estats Units d'Amèrica --- Ètats-Unis d'Amèrica --- États-Unis d'Amérique --- Fareyniḳṭe Shṭaṭn --- Feriene Steaten --- Feriene Steaten fan Amearika --- Forente stater --- FS --- Hēnomenai Politeiai Amerikēs --- Hēnōmenes Politeies tēs Amerikēs --- Hiwsisayin Amerikayi Miatsʻeal Tērutʻiwnkʻ --- Istadus Unidus --- Jungtinės Amerikos valstybės --- Mei guo --- Mei-kuo --- Meiguo --- Mî-koet --- Miatsʻyal Nahangner --- Miguk --- Na Stàitean Aonaichte --- NSA --- S.U.A. --- SAD --- Saharat ʻAmērikā --- SASht --- Severo-Amerikanskie Shtaty --- Severo-Amerikanskie Soedinennye Shtaty --- Si︠e︡vero-Amerikanskīe Soedinennye Shtaty --- Sjedinjene Američke Države --- Soedinennye Shtaty Ameriki --- Soedinennye Shtaty Severnoĭ Ameriki --- Soedinennye Shtaty Si︠e︡vernoĭ Ameriki --- Spojené staty americké --- SShA --- Stadoù-Unanet Amerika --- Stáit Aontaithe Mheiriceá --- Stany Zjednoczone --- Stati Uniti --- Stati Uniti d'America --- Stâts Unîts --- Stâts Unîts di Americhe --- Steatyn Unnaneysit --- Steatyn Unnaneysit America --- SUA (Stati Uniti d'America) --- Sŭedineni amerikanski shtati --- Sŭedinenite shtati --- Tetã peteĩ reko Amérikagua --- U.S. --- U.S.A. --- United States of America --- Unol Daleithiau --- Unol Daleithiau America --- Unuiĝintaj Ŝtatoj de Ameriko --- US --- USA --- Usono --- Vaeinigte Staatn --- Vaeinigte Staatn vo Amerika --- Vereinigte Staaten --- Vereinigte Staaten von Amerika --- Verenigde State van Amerika --- Verenigde Staten --- VS --- VSA --- Wááshindoon Bikéyah Ałhidadiidzooígíí --- Wilāyāt al-Muttaḥidah --- Wilāyāt al-Muttaḥidah al-Amirīkīyah --- Wilāyāt al-Muttaḥidah al-Amrīkīyah --- Yhdysvallat --- Yunaeted Stet --- Yunaeted Stet blong Amerika --- ZDA --- Združene države Amerike --- Zʹi︠e︡dnani Derz︠h︡avy Ameryky --- Zjadnośone staty Ameriki --- Zluchanyi︠a︡ Shtaty Ameryki --- Zlucheni Derz︠h︡avy --- ZSA --- Η.Π.Α. --- Ηνωμένες Πολιτείες της Αμερικής --- Америка (Republic) --- Американь Вейтьсэндявкс Штаттнэ --- Америкӑри Пӗрлешӳллӗ Штатсем --- САЩ --- Съединените щати --- Злучаныя Штаты Амерыкі --- ولايات المتحدة --- ولايات المتّحدة الأمريكيّة --- ولايات المتحدة الامريكية --- 미국 --- Spojené obce severoamerické --- États-Unis --- É.-U. --- ÉU