Social support, disability and independent living of elderly persons in the United States

This article examines the effects of the availability of kin and disability on the ability of elderly persons to live alone in the United States. The first part of the article uses a sample of women aged 65 and over from the 1980 census to study the factors associated with both living in group housing and living alone. Disability and absence of a spouse or children are strongly associated with living in group housing, whereas lack of disability and lack of children are associated with living alone. In the second part, data from the Supplement on Aging to the 1984 National Health Interview Survey are used to investigate the source and amount of help received among those with difficulties in performing Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs). Those living alone or with nonrelatives are most likely to rely on paid help and this is more likely if they have few living children.     

SOCIAL SECURITY AND AGGREGATE CAPITAL ACCUMULATION REVISITED: DYNAMIC SIMULTANEOUS ESTIMATES IN A WEALTH-GENERATION MODEL

This paper re-examines Feldstein's(1974, 1982)results of the effect of social security on private capital accumulation in the context of a simultaneous-equation model of capital accumulation. The model incorporates dynamic feedback effects in capital accumulation and is estimated by FIML to incorporate theoretical restrictions that are tested against the data. It is then simulated as a full dynamic model to analyze the long-run effect of SSW on private capital accumulation. The simulated effects are in the same direction as found by Feldstein, but are considerably weaker.     

Pre- and post-planned evaluation: Which is preferable?

This paper compares the advantages and disadvantages of the “pre-planned” and “post-planned” approaches to evaluating program effectiveness. These evaluative approaches are compared along a number of dimensions which include: (a) Reliability of data and the cost of collecting it; (b) Internal validity; (c) External validity; (d) Evaluation obtrusiveness and threat; and (e) Program goal displacement and program direction. A model designed to help program managers decide when and under what conditions either of these two evaluative approaches should be employed is presented. One major theme throughout this discussion is that despite the growing interest in and use of pre-planned evaluation, the post-planned method has many advantages which often go unnoticed. This paper will help program administrators, planners and evaluators in selecting and implementing these two methods in light of their respective strengths and limitations.     

Physicians lead the way at America's top hospitals

The 100 Top hospitals are selected annually based on seven critical parameters for each of the 6,200-plus U.S. hospitals with 25 or more beds. They include the previous year's risk-adjusted patient mortality and complication rates, severity-adjusted average patient lengths of stay, expenses, profitability, proportional outpatient revenue, and asset turnover ratio (a measure of facility and technological pace-keeping ability). The winners are selected from five comparable size groupings--small, medium, large community, teaching, and large academic hospitals. Conspicuous among the winners at every level are physician-led organizations. Even in the majority of hospitals headed by non-physician administrators, however, the managerial capabilities of medical directors are the key to success. The most common characteristic of these award-winning hospitals is that the leadership is working together and communicating the institution's goals effectively to all levels of the organization.