Discrimination and pension income among aging women.

Using data from the National Longitudinal Survey of Labor Market Experience, Mature Women's Cohort, this study examined the extent to which discrimination influenced pension receipt and levels of pension income among women aged 55-69 in 1992. It found that discrimination affected the level of pension income beyond that of demographic and human capital variables, when controlling for wage-related income, only among moderate-to-affluent near-elderly women. No relation was found between discrimination and receipt of pension income.

An assessment of employers' experiences with HMOs: factors that make a difference.

This study investigated those factors that influenced employers' experiences with health maintenance organizations (HMOs). It examined a national cross-sectional sample of chief executive officers (CEOs) and benefits managers. Findings revealed that different administrative issues such as the volume of paperwork, confusion about benefits, and educating employees about HMO benefits were of primary importance in affecting management's experiences with HMOs. Differences were found between CEOs' and benefits managers' responses.

Managing information systems: an ethical framework and information needs matrix.

This paper urged administrators in human services to attend to values and ethics in the design and implementation of automated information systems. Toward this end, it presented an ethical framework reasserting the primacy of clients as citizens and encouraging the development of client-driven information systems. Finally, the paper presented the rationale for and two examples of an Information Needs Matrix to assist administrators in their deliberations about allocating discretionary resources among functional units within organizations.

Adding a competitive dimension to importance-performance analysis: an application to traditional health care systems.

This study introduced an extension of importance-performance analysis by further including the performance of competitors. It demonstrated its value by applying it to a national sample of fee-for-service health care users. This study found that inappropriate strategies may result from importance-performance analysis that excludes a dimension of competition. In particular, the two attributes, availability of both physicians and emergency services, were found to be "high" on importance and "good" on fee-for-service performance. From the basic classic importance-performance approach, a relatively passive strategy would be recommended for each of these attributes. When also considering competition, however, a more appropriate, vigorous strategy of head-to-head competition clearly emerges.

HMO viability and the economically disadvantaged.

This study uses data from the 1984 Kaiser Foundation national health care survey to assess the viability of HMOs for the economically disadvantaged in light of important health care attributes. To achieve this, the paper examines their satisfaction with different health care attributes and their preferences for alternative health care systems with respect to these same attributes. These data are used to assess overall health care system preference. This study found that the economically disadvantaged population was largely indifferent between an HMO or traditional fee-for-service health care system. This finding supported the prospect that the economically disadvantaged and Medicaid beneficiaries were somewhat amenable to HMO coverage. A fairly strong preference for fee-for-service health care system was found with respect to the quality of care attribute. This suggests that the economically disadvantaged will view HMOs as the health care system of choice depending on their ability to provide quality care. In light of these findings, several policies are recommended.

The role of health care attributes and demographic characteristics in the determination of health care satisfaction.

The authors investigate the influence of demographic characteristics and health care attributes on overall health care satisfaction. They use a national cross-section sample of HMO members and another of non-HMO members. Demographic characteristics are treated as antecedent to satisfaction with the health care attributes in the determination of overall health care satisfaction. The health care attributes are very similar in impact for both samples, suggesting HMOs should emphasize those attributes both to ensure reenrollment and to encourage new enrollment. Findings also show that satisfaction with several health care attributes varies along a few demographic dimensions, suggesting demographic bases along which the health care market can be segmented.

Determinants of health care satisfaction: a national study of HMO and fee-for-service consumers.

This study examines the extent to which different health care attributes determine health care satisfaction. It employed two national cross-sectional samples, one of HMO members and the other of NON-HMO health care users. The comparative analysis revealed that the pattern of results for both samples were similar. The two most important attributes for both samples were health care costs and availability of specialists. Results suggest different marketing and related management strategies.

Intentions to join HMOs: perceived relative performance versus satisfaction/dissatisfaction.

This study employed a national sample to investigate the determinants of consumers' intentions to join HMOs by considering different health care attributes. It employed two models, a performance model and a satisfaction model. The study found that the robustness of the performance model was substantially stronger in explaining intentions to join HMOs than the satisfaction model. More specific findings indicated that the health care attributes of cost and quality of care were important in both models, although to a far greater extent in the performance model, and that availability of physicians was also important in the performance model, albeit to a lesser degree. The study also examined demographic characteristics that may serve as a basis for segmenting the health care market. Of those considered, only two, age and urban/rural residence, were found to be significant. Age was considerably the more important of the two and younger respondents were far more interested in joining HMOs than their older counterparts. The pattern of results for the young subsample paralleled those found for the entire sample.

The role of information systems in evaluation research.

The author suggests four ways that management information systems can complement the efforts of program evaluators. These ways are: clarifying the purposes of and uses for collecting information; clarifying the relevancy of information that is collected and stored; constructing a data base that accounts for the differential needs of users; and generating reports in a timely and comprehensible manner. Interwoven throughout these ways is the premise that program evaluators need to attend more to the decisional needs of various users, particularly managers. An information system can assist program evaluators toward this end.