Artifact in client satisfaction assessment: experience in community mental health settings

Artifact in client satisfaction assessment is discussed and the results of a study of three factors thought to mediate client satisfaction ratings; (a) general life satisfaction, (b) mode of administration, and (c) psychological symptomatology, are reported. A standard client satisfaction questionnaire (CSQ) was modified to yield parallel forms and was administered orally and in writing to 92 clients in two mental health day treatment programs. Satisfaction ratings obtained from these clients were quite similar to out-patient ratings obtained in previous studies conducted in this setting and using the same measures. Oral administration of the CSQ produced 10% higher satisfaction ratings than written administration (p less than .05) and less missing data (p less than .01). Satisfaction ratings were also obtained using a simple graphic instrument. Graphic ratings were comparable to CSQ ratings. Satisfaction with life in general and level of psychiatric symptoms together accounted for 25% of CSQ variance. The implication of these findings for future client satisfaction research is discussed.     

Perceived morbidity, utilisation of health services and factors affecting it in a rural area

A survey of perceived morbidity was carried out in rural population in eight villages and four wards of Saoner town, covering a total population of 8,876. The nature of illness was assessed by weekly visits to the families. History regarding treatment taken for disease and its source was taken. The overall incidence of perceived morbidity was 176.35 spells of sickness per 1000 population per month. Health care agency was contacted for 36.7 per cent spells of sickness. Utilisation of health services was found to be affected significantly by factors like age (chi 2 = 138.36), literacy (chi 2 = 14.123), type of occupation (chi 2 = 433.74), nature of illness (chi 2 = 83.578) and accessibility of health services. A health behaviour model of the population has also been discussed in this paper.     

The administrative costs of non-profit health insurers

Interest in the efficiency or inefficiency of non-profit firms has spawned research on the administrative costs of Blue Cross and Blue Shield plans. Relying on plausible implications of the property rights theory of the firm, both Blair, Ginsburg, and Vogel (1975) and Vogel (1977) noted some evidence of inefficiency in these firms. Our analysis, however, utilizing their models and more recent data, reveals little convincing evidence for the view that Blue Shield plans are inefficient.     

Social forecasting: An integral part of corporate planning?

The increasing need for business to monitor the social dimensions of its environment and, hopefully make some forecasts of future trends has met with some constructive response from academics and consultants although not as yet on a very liberal scale. The published literature does not indicate to what extent companies in general attemp social forecasting and, where they do, the degree of integration which exists within their corporate planning systems. The authors, therefore, decided to survey a sample of British organizations to see if they could shed some light on these issues and thereby add some information to the excellent accounts of individual cases of social forecasting in, they suspect, the more advanced and atypical companies. The survey suggests a general picture of: awareness of the value of social forecasting; fairly widespread ignorance of the techniques which do exist, primitive though these may largely be; successful integration of social forecasting into the corporate planning systems of a substantial number of organizations but not in the majority.     

Coordination and citizen participation

This study investigates the validity of the assumption that coordination and citizen participation are related inversely and, thus, are incompatible as features in the same social service reform strategy. Seventeen social service organizations situated in the same urban area were studied. Data were obtained by structured interview. The concepts of coordination and citizen participation were operationalized by means of scales. The findings support the validity of the assumption noted above. Although interpretations of the findings can be provided, they are post-factum. This implies a need for explanatory research which might be guided by theories of community power structure and of organizational behavior.     

Evaluating a private foundation's health program

Public policy decisions in health are increasingly difficult and expensive. Although there will never be enough information available, private foundations can help to bridge the most important gaps in knowledge. Larger foundations may also wish to respond to those who doubt the value of foundation activities. This article reviews the experiences over the past eight years of The Robert Wood Johnson Foundation in employing evaluation and related social research procedures in the planning and implementation of a major philanthropic effort to improve the health and medical care of Americans. Discussed are the still evolving Foundation evaluation framework, the unanticipated problems in undertaking specific evaluations, and the substantive findings of some of the studies.     

The management of offshore resources—Some implications of the 200-mile limit

This article examines in depth the strategic implications for those States who have recently declared 200 mile off-shore resource management zones. The authors, in a comprehensive and stimulating paper, examine the implications of so-calling a nation's offshore limit. It is an appropriate name for a nation's offshore limit since the primary reason for many nations declaring a 200 mile limit has been the abundance of resources which have often been found within those limits either in the sea or the sea bed itself. This paper reviews the current background of off-shore resource management and outlines suitable roles for adoption by the coastal States in the management of their off-shore renewable and non-renewable resources. Furthermore, it examines the contentious but nonetheless central issue of the benefits and costs which accrue through coastal state jurisdiction. The authors also examine an appropriate resource management process and the implications of resource use conflicts within the off shore limit as well as defining these conflicts on the basis of ‘stakeholder’ interests and introduces a new concept of the maximization of economic equity amongst competing stakeholders. The problem remains that the measurement of economic equity perhaps leaves the States concerned within a situation of only having defined the problem; the political process has then to deal with any reallocation measures that may be deemed appropriate.     

Declining world fertility: trends,causes, implications

This Bulletin examines the evidence that the world's fertility has declined in recent years, the factors that appear to have accounted for the decline, and the implications for fertility and population growth rates to the end of the century. On the basis of a compilation of estimates available for all nations of the world, the authors derive estimates which indicate that the world's total fertility rate dropped from 4.6 to 4.1 births per woman between 1968 and 1975, thanks largely to an earlier and more rapid and universal decline in the fertility of less developed countries (LDCs) than had been anticipated. Statistical analysis of available data suggests that the socioeconomic progress made by LDCs in this period was not great enough to account for more than a proportion of the fertility decline and that organized family planning programs were a major contributing factor. The authors' projections, which are compared to similar projections from the World Bank, the United Nations, and the U.S. Bureau of the Census, indicate that, by the year 2000, less than 1/5 of the world's population will be in the "red danger" circle of explosive population growth (2.1% or more annually); most LDCs will be in a phase of fertility decline; and many of them -- along with most now developed countries -- will be at or near replacement level of fertility. The authors warn that "our optimistic prediction is premised upon a big IF -- if (organized) family planning (in LDCs) continues. It remains imperative that all of the developed nations of the world continue their contribution to this program undiminished."