MARKET STRUCTURE, DURABILITY, AND QUALITY: A SELECTIVE SURVEY

This essay provides an expository survey of that branch of the theoretical literature on product quality determination which assumes that quality can be represented by a scalar. The bulk of the work discussed associates that scalar with durability. Peter Swan's result that market structure has no impact on quality is derived in a straightforward way, and the assumptions on which it rests are identified and discussed. The consequences of relaxing these assumptions, as revealed by the subsequent literature, are described. The general implications of the durability literature are summarized .     

The Enduring Relevance of Case Management

Correspondence to Peter Ryan, School of Health, Biological and Environmental Sciences, Middlesex University, Archway, 7, Highgate Hill, London N19 5NF Summary This article summarizes the main results and policy implicationsof a Department of Health funded mental health case managementresearch and development project. The project implemented casemanagement services in four different sites, and worked withclients who were severely disabled with long-term mental illness.Higher levels of engagement (95 per cent) were achieved by case-managedas compared to control clients. They were also linked to a widerrange of community services. However, costs of the experimentalservices were higher, and client outcome variable. In two sites,case-managed clients achieved significant improvements in psycho-socialadjustment, whereas on the third site, there were no differencesin outcome between the control andexperimental clients. The article concludes that case management continues to be amode of service delivery which can achieve real benefits forclients in terms of preventing them from falling through thenet, and in linking them in responsive ways to community services.However, the increased costs can make it an unattractive optionfor purchasers, and ways need to be found to retain the establishedbenefits, whilst reducing the costs to service purchasers.