Mike Luck

Cultural differences in functional ability among elderly people in Birmingham, England, and Glostrup, Denmark.

The purpose of this article is to compare patterns of functional ability among four groups of elderly people with different cultural backgrounds. The data originates from (1) a study of 369 65 to 74 year old people in Birmingham, born in England, the West Indies, and Asia, and (2) a study of 734 rafter homogeneous 70 year old people in Glostrup, Denmark. In both surveys functional ability was measured by interviews about Physical and Instrumental Activities of Daily Living (PADL and IADL). With regard to PADL there were only a few differences between the four study populations, whereas larger differences were found in IADL. The general pattern was that the Glostrup population had better functional ability than the other study populations and that Asians had the poorest functional ability. The reasons for these differences may arise from different patterns of disease, variations in life style, and differing access to and response from social and health services in the four cultural groups.

Working women in the sex industry and their perception of risk from HIV/AIDS

The present research project provided women who are normally marginalized by society with an opportunity to give their opinions on health matters that are directly related to their working and personal lives. Discussion groups were held with women working in saunas or massage parlors (the sex industry) to obtain their views on sexual health and the risk of infection from the human immunodeficiency virus. The sauna workers said they have less chance of becoming infected than women not working in the sex industry, because they are very careful about their activities in the sauna. The women were very concerned about their children and wanted information to give to their children rather than for themselves. Although these women used condoms at work, they said they were reluctant to use condoms in their social relationships because of the association with work.

Fundholding and the Community Nurse

A B S T R AC T General Practitioner fundholding has been shown to enjoy a number of advantages over centralised systems of purchasing: it is more consumer sensitive, shakes up providers, shifts resources into primary care, enables expert understanding and skills to inform the purchasing function and ensures that treatment quality will have priority over cost savings. These benefits are offset by the very significant drawbacks of extra resources being needed for administration, limitations on purchaser power and the danger that the internal market principle will be undermined. This article examines the extent to which these effects are applicable in the specific context of purchasing of community nursing services that took effect from April 1993. It is found that few of the above advantages are applicable in the community setting and that the disadvantages are particularly severe. The solution may be to combine formal centralised contracting with an element of competition at the operational level to produce a more ‘organic’ system than hitherto visualised.

Market research in health and social care

The shift to managed markets means that planners and purchasers of health and social services seek information on needs, while managers who provide these services seek information on performance and response. Market research contributes to both. This text is an introduction to the relevance, planning and management of market research in the areas of health and social care which have developed in Britain and most other industrialized countries. Intended for both managers and students of public sector management and marketing, the book contains instruction on research methods with a selection of real case studies. The book features: an explanation of how managed markets provide the context for market research; a guide to choosing the appropriate survey method; recommendations for commissioning, monitoring and implementing results; practical advice on producing successful student projects; and a comparative international perspective.

Developing applied OR teaching in Asia

Abstract A workshop for OR teachers in Asia was proposed at IFORS 84 and took place at the Indian Institute of Management, Ahmedabad, in March 1986. The main purpose of the Workshop was to increase the teaching of OR as an applied subject relevant to decision making. The primary topics in the programme were the use of case exercises, computing in OR, and student projects. A number of proposals for follow-up activities were made, including networks for the exchange of case material and information on software. The paper includes a brief report on activities which have taken place since the Workshop.

Health visitors revisited

Abstract Cambridgeshire Area Health Authority commissioned a team from the University of Aston Management Centre to carry out an operational research project in order to assist in planning the provision of health visitor services in Peterborough health District. Since Peterborough is a Development Area there has been a rapid increase in population which it is planned will continue for some years. This change in size and age-distribution of the population poses considerable problems for planning the provision of health visitor services. Health visitors are trained nurses who have highly independent roles in the National Health Service. They are largely concerned with preventive work, traditionally with children and increasingly with the elderly, in which it is difficult to set quantitative objectives and measure outputs. This paper will describe the research plan and the models developed. Considerable attention will be paid to the relationship of the research team to the client system, consisting of the Area and District managers and the individual health visitors. The implications of this type of study in extending the practice of O.R. will be considered.

Qualitative and Quantitative Models of Social Behaviour with Respect to Health Promotion and Waste Disposal

At the 1964 Operational Research and Social Sciences Conference all the papers dealt with decision making in formal organisations (Lawrence, 1966). There were no papers concerned with health promotion or waste disposal nor were there any papers which dealt with the social behaviour of individuals and households. In the intervening 25 years there has been only limited progress.