Court decisions hold implications for managed care plans--Part one

The managed care industry--and HMOs in particular--is now facing the realities of a maturing business. Maturity has brought a competitive tension to the HMO/managed care field, one consequence of which is increased litigation, not only among HMOs but also between HMOs and their suppliers, customers, and indemnity insurers. Entanglement in the legal system is an outgrowth of efforts to gain or preserve a competitive edge, reduce costs, and attract customers. This article highlights selected legal developments from the past two years that reflect the causes and effects of this environment. Additional cases will be discussed in the March-April 1990 issue of the journal.     

A cost benefit analysis of the barbados family planning programme

Abstract Of the Caribbean islands, Barbados has the lowest fertility level. The crude birth rate in 1970 was only 20·5 per 1,000, which is one of the lowest found in any country of similar economic development anywhere in the world. In 1960 the crude birth rate was much higher, at about 33·6 and for almost 40 years before that had fluctuated around a value of 33. Thus, a decline of about 40% has been achieved within the comparatively short period of a decade. The reasons for this rapid decline are of particular interest to all those concerned with population growth and economic development in the less developed areas. In Barbados, the importance of population control and the role of family planning was recognised early by the government and other civic agencies, and the Barbados Family Planning Association (BFPA), an autonomous national family planning agency, was established. Since its modest beginning in 1955 the BFPA has grown to be a major social institution, comprising 14 clinics situated in various localities throughout the island. In 1970, a full-time staff of 28 were providing services to an estimated 10,000 clients, about 20% of all women of reproductive age. Funds for the BFPA have come from local government with considerable assistance from international agencies.     

Some social implications of personnel planning

It would appear that most discussions on manpower or personnel planning are concerned with highlighting the dichotomy between organizational needs and personal needs. The assumption that these two separate need areas can be successfully harmonized through personnel planning is implicit. In this paper the intention is to discuss this relationship in terms of the consequences for employees of attempts to achieve the aims of organizational manpower plans through the establishment of personnel control mechanisms.     

Stability of retrospective reports in depression: traumatic events,past depressive episodes,and parental psychopathology

Research findings based on the retrospective reports of depressed individuals have long been held suspect because of possible negative reporting biases associated with depression. In the present study we assess the stability of retrospective reports of past traumatic events, past depressive episodes, parental depression, and parental substance abuse in a sample of 234 adults whose depression status changed over two assessments conducted one year apart. Depression status was found to affect reporting of number of past depressive episodes and past traumatic events, but not reporting of parental psychopathology. Implications of these findings are discussed for research that relies on the retrospective self-reports of depressed participants.