The dysfunctional side effects of quantitative indicator production: illustration from mental health care (a message from Chicken Little)

In the current context of economic conservation, accountability and retrenchment from social programs, justification is required in order to maintain human service capacity. In this effort, evaluation is a key component. Yet desire to base action upon information resulting from evaluation must be tempered by increased attention to the effects of the evaluation process. All too often premature application of quantitative indicators formerly used for individual assessment and research to bureaucratic decision making produces side effects that are dysfunctional in nature. Frequently these side effects influence service delivery directly. More insidious, because they are less easily discerned, are distortions introduced into the data by evaluation pressure. These not only delay effects on service but also impair understanding of the very process they are meant to illuminate. In order to illustrate this phenomenon, the author reviews a general literature and utilized examples from mental health care. Common themes are identified and a tentative theory of side effect generation proposed.     

Strengths, uses and problems of global scales as an evaluation instrument

A global scale can provided means for integrating a variety of client/patient assessment techniques to complement each other in a useful manner. Global scales have been applied to service planning and evaluation as well as being useful for the on-going communication of clients' clinical/functioning status. Global scales are attractive to many service programs because of their apparent ease of implementation and their apparent face validity. Furthermore, there is an extensive body of literature describing global scales as hightly reliable and valid when properly implemented and maintained. The literature also suggests that there are some serious pitfalls. While initial implementation of a global scale is easy, the maintenance of a reliable, valid and useful scale appears to require their active use in treatment planning, treatment review and clinical supervision processes. It also requires that more extensive multidimensional ratings be made at intake, review and termination. Furthermore, staff training and development sessions two or three times a year are needed to surface and deal with differences in clinician ratings. Given these sorts of supports, then, a global scale has been demonstrated as a useful tool in service program management as well as clinical process and outcome studies, including studies of cost effectiveness. Since the major use of a global scale is as an integrating construct, a quantitative model is offered to describe the relationship between global scale ratings and multidimensional facets influencing the global ratings.     

九一八事变前张学良对日抵制政策探析——兼论九一八事变爆发的背景

张学良主政东北后,为了摆脱日本的控制,毅然改旗易帜,服从国民政府。他对内进行"东北新建设",增强东北的实力,以抵制日本势力的入侵;在对日外交上,他设法限制或抵制日本在东北的权益,甚至公开实施对日抵制政策,并支持东北民众的抗日救亡运动。张学良对日抵制政策的实施,一方面维护了国权,促进东北救亡运动的发展;另一方面,引起了日本的极大恐慌,日本以"中国官民共同排日"致使"满蒙危机"为借口之一,打造战争舆论,发动九一八事变。     

Small area indicators and social change

This article examines the relevance of measures of social change for small areas and how these can be used in need assessment. Specifically, this article explicates the problems of selecting a limited group of indicators from among the broad panoply of indicators available, and of determining the different kinds of information provided by indicators controlling for the level of aggregation. The use of small area social indicators to do need assessment is illustrated using data from the 1970 and 1980 Health Demographic Profile System.