Program analysis using the client oriented cost outcome system.

The client oriented cost outcome system has been under development in Pennsylvania community and hospital programs since 1972. The system builds upon the behavioral and decision data generated with or on behalf of consumers. Flexibility for local program system design is permitted if the procedures of consumer intake, review, and termination document each consumer's (a) problems, resources, and goals, (b) overall functioning level in their ordinary community, and (c) services intended and rendered as related to (a), above. While the system's primary application is in providing feedback for local program quality assurance and evaluation procedures, aggregation of data permits program planning and evaluation at county, state, and federal levels in terms of (a) client demographic or diagnostic characteristics, and (b) program service characteristics and objectives.     

Optimal Times to Contact Sample Households

Finding a suitable respondent at home is an essential and expensivecomponent of a household survey. This article reports on theresults of a study of the probabilities of finding someone aged14 or older at home and discusses the application of such datato survey design and budgeting.     

The health demographic profile system: current and longitudinal data base for social area analysis

The development of the Health Demographic Profile System, which is based on the 1980 census, is described. The system includes social and economic indicators designed to identify high risk target populations, in terms of mental health and general health service needs, as well as to describe the social and economic structure of both mental health service and other small geographic areas. The report describes: (1) the original system, that is, the Mental Health Demographic Profile System (MHDPS), which is based on the 1970 census, including details of the approach and content, (2) the 1980 provisional indicators and planned products, (3) plans for the development of a longitudinal system based on 1960, 1970, and 1980 data, and (4) current and future studies related to the 1980 Health Demographic Profile System.     

Complaint as a form of association

Complaining is a common pattern of interaction that can be viewed as a form of association. Our understanding of complaint and other forms of association is enhanced by applying insights from Simmel's formal sociology. The emergence of complaint, like other forms of association, adheres to a general developmental process and has specifiable social consequences. The integrative and disintegrative social consequences of complaint are spelled out.     

Out-migration and ethnic communities

"Comparative analysis of out-migration [in the United States]...reveals substantial ethnic differentials. Part of the variation results from group compositional differences in social class and other characteristics normally related to migration, particularly age, education and local birth. Equally important, however, are indicators of social and economic bonds." The data concern 3,345 adults who were first interviewed between 1967 and 1969 in Rhode Island and were reinterviewed in 1970, 1971, and 1979. "The results suggest that ethnic groups characterized by a dense network of social and economic ties do not sponsor out-migration, which has been the emphasis of many past studies of chain migration and migrant assimilation. Rather, they deter out-migration by providing alternative opportunities within the ethnic community."     

International and internal migration decision making: a value-expectancy based analytical framework of intentions to move from a rural Philippine province

"The study compares determinants of internal and international migration intentions, drawing upon interview data from a sample of adults in Ilocos Norte, a largely rural province in the Philippines. A regression model is applied to test the relative determinants of intentions to migrate to Manila and to Hawaii. The study is based on a value-expectancy model of migration decision making. The results document the importance of subjective expectations related to the attainment of different values and goals in Manila and Hawaii."     

Cohort size effects and migration

"This article explores whether changes in the size of [U.S.] cohorts entering the labor force affect the propensity to migrate and the socioeconomic circumstances of migrants at destination. The flow of young in-migrants to large SMSAs declined during the 1965-76 period, but the relative socioeconomic standing of migrants at destination was unaffected by either cohort size or regional differentials in economic growth. It is suggested that a significant reduction in the volume of migration among members of the baby boom cohort was the primary adjustment mechanism, hence reducing the need for degrading the opportunities available to migrants."     

Patient satisfaction with mental health services: a meta-analysis to establish norms

Patients typically express high rates of satisfaction with their mental health care. This finding and the lack of well controlled studies on patient satisfaction in the literature underscore the need for meaningful guidelines for clinicians and program evaluators in interpreting patient satisfaction data. To address this problem a meta-analysis was undertaken to establish norms on patient satisfaction for various types of mental health programs. Programs were categorized according to three dimensions: inpatient vs. outpatient vs. residential care; chronic vs. non-chronic; and conventional vs. innovative. Meta-analysis procedures were modified to accommodate the single-group study designs that dominate the literature. The analysis revealed that chronic patients express less satisfaction with their treatment compared to non-chronic patients. Innovative programs are viewed more positively than conventional ones. No differences were found in rates of patient satisfaction between inpatient and outpatient programs. Acceptably reliable norms and confidence intervals of patient satisfaction were established for conventional inpatient programs serving either chronic or non-chronic patients; conventional outpatient programs for non-chronic patients; and for all programs combined according to chronic vs. non-chronic, inpatient vs. outpatient, and conventional vs. innovative. However, data were insufficient to compute norms for other program types. The norms thus established can be used for comparative purposes by program evaluators. A cumulative, national data base on patient satisfaction is recommended to further refine these norms.     

The effects of psychiatric symptoms on quality of life assessments among the chronic mentally ill

This study of chronically mentally disabled persons in community residences examined the discriminant validity of subjective quality of life indicators and self-report mental health indices to determine the potential confounding effects of psychopathology on the assessment of quality of life (QOL). Factor analyses and difference-score reliabilities identified a general QOL construct and a general mental health construct with 27% common variance. However, psychiatric symptoms did not significantly (p less than .05) alter the bivariate and multivariate relationships among the QOL ratings, except in the health domain in which the correlations of health-related QOL indicators with global QOL were significantly (p less than .05) attenuated after removing the effects of psychopathology. The results suggest that psychopathology does not introduce bias into the overall structure of QOL data, but they also indicate the importance of controlling for mental health effects in the assessment of patients' self-rated health and satisfaction with health care.