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Keynote address.

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Cost Control

Economic, life, and disorder changes: time-series analyses.

Implicit in recent social science research and political discussions is a model linking the economy to mental disorder through the intervening constructs of life change and trauma. Using time-series analysis of a 16-month survey in Kansas City, Missouri (n = 1,140), economic and noneconomic life events and the Midtown scale were predicted using a variety of economic measures for the standard metropoliton statistical area. Both life event variables and the symptom measure were related positively to unemployment, and absolute economic change measures lagged 1 and 2 months. However, the life event variables were not strongly associated with the Midtown scale. Most striking of the subgroup findings was that, on the Midtown scale, the low-income group was more responsive than the middle-income group to economic fluctuations.

Adolescent

This is the way it was in the 1970s.

Although regulatory, economic, and other concerns appear to have taken center stage in the health care field in the past decade, the real work of healing and comforting the sick goes on.

Cost Control

Forces for reforming the U.S. health care system: a review of the cost and access issues.

In recent years, a spate of health care reform proposals have emerged on the American agenda. Although the elements of the reform proposals often vary substantially, most of the initiatives are fuelled by two common concerns: rising health care expenditures and a growing uninsured population. National health spending, for example, commands an increasing share of U.S. gross national product despite numerous cost-containment efforts initiated by public and private payers throughout the 1980s. And the uninsured population continues to grow--by an estimated 30 percent between 1978 and 1989. To facilitate understanding of the public policy options being considered to address these concerns, the article examines U.S. health care expenditure data and some of the causes of rising health care costs. The article also discusses the demographic characteristics of the uninsured population, the reasons why they lack health coverage, and the health consequences associated with being uninsured.

Cost Control

Pooling international health care expenditure data.

The purpose of this paper is twofold. The first is to analyse the statistical relationship between real health care expenditure per capita and aggregate income, public share in finance, age-dependency ratio and inflation. The second purpose deals with methodological problems involved in pooling health care expenditure data. The empirical work is based on pooled cross-sectional, time-series data for 22 OECD countries from 1972 to 1987. Public finance share and inflation were found to be associated with lower per capita health care expenditure. No consistent correlation was found between the age-dependency ratio and health care expenditure. Contrary to results of earlier studies, we found that health care expenditure does not appear to be income (GDP) elastic. However, the results do not appear to be robust to changes in the time periods and countries included.

Age Factors

Employment of full-time staff outpaces part-time growth.

Data from the AHA's Hospital Panel Survey show faster growth in hospitals' full-time staffs than in their part-time staffs in the first six months of the year. And slower labor cost growth was offset by fast non-labor cost growth.

American Hospital Association