Equity and Efficiency Policy in Community Care Needs, Service Productivities, Efficiencies and Their Implications

This title was first published in 2000: Equity and Efficiency Policy provides a completely new perspective on post-reform community care, analyzes its fairness, effectiveness and efficiency in a new way and uses its powerful new techniques applied to a major national collection of evidence to suggest how to develop the Modernization Agenda. It - describes, for the first time, how differences in the levels of each of the main services alone and in combination affect a wide range of user and carer benefits; - uses this knowledge to analyze in a new way and make policy proposals about some of the pressing policy issues of the government’s Modernization Agenda.

Contents: Introduction: policy context and research design. Mapping Productivities and Service Outputs: Modeling the impact of service inputs on outputs: framework and indicators; Estimating production functions; Productivities for DAYS indicator variable (user’s length of stay in the community); Productivities for USATISF indicator variable (overall satisfaction with services); Productivities for IMPADL, IMPIADL and NSF indicator variables (perceived improvement in functioning in service-related areas and reported unmet needs); Productivities for IMPEMP, UEMPOW, CEMPOW indicator variables (empowerment, choice and control); Productivities for PGC, GDL, DLD indicator variables (general psychological well-being); Productivities for IMPREL and SATSOC indicator variables (reduction in social exclusion and improvement in relationships); Productivities for WKSAT indicator variable (worker perception of impact); Joint supply in the production system; Service productivities: the main patterns. Equity and Efficiency: Actual and Optimal: Equity and efficiency analysis: assumptions and methods; Efficiencies for DAYS indicator variable (users’ length of stay in the community) Efficiencies for USATISF indicator variable (degree of satisfaction of user with the overall level of service received); Efficiencies for IMPADL indicator variables (degree of improvement in personal care functions of daily living ascribed by user to social services); Efficiencies for IMPIADL indicator variable (degree of improvement in household care and other instrumental care functions of daily living ascribed by user to social services); Efficiencies for IMPEMP indicator variable (user felt control over own life score); Efficiencies for DLD indicator variable (user dissatisfaction with life development score); Efficiencies for KOSBERG indicator variable (felt burden of caregiving); Efficiencies for WKSAT indicator variable (worker perception of impact); The world viewed in the looking glass: the sy

Bleddyn Davies, José Fernandez with Bulent Nomer, PSSRU at the London School of Economics and the universities of Kent and Manchester, UK