Developing economics expertise for the evaluation of primary health care

Given that government budgets are increasingly stretched in the face of competing demands, there is a pressing need for evidence on the costs and benefits of public sector investments. Nowhere is this need greater than in the health field, where the benefits of programmes are typically difficult to measure. Within the health sector a key area of interest is primary health care, which is generally regarded as a central function and the most important means by which the health of the population can be improved. This paper reports the results of a recent survey of Commonwealth countries which sought to establish the extent of economic evaluation of PHC programmes, the impact on decision-making and the level of health economics expertise available in Third World countries. Based on the results of the survey, suggestions are made for improving the commissioning and conduct of economic evaluations, for interpreting and implementing evaluation results, and for developing government expertise in economic evaluation.     

Differentiating specialists and generalists within college students' social support networks

In order to examine the relationships among social network structure, types of social support, and determinants of support satisfaction, an alternative method was used to score the Social Support Questionnaire (SSQ). Factor analysis procedures suggested that college students' (N=198) social networks consisted of four groups: nuclear family, other family, friends, and others. Satisfaction with support was positively related to the proportion of the network occupied by nuclear family and negatively related to the proportion of friends in the network. Evidence was found for the presence of both support specialists and support generalists in the networks of the college students. These results are discussed from a developmental perspective with attention to the implications for interventions.     

The political process and the use of debt financing by state governments

Empirical evidence offered in this study suggests that decisions by state government officials to effect debt-financed spending depend in part on the state's gubernatorial election cycle. More specifically, the results reveal relative increases in state debt issues in anticipation of elections, and furthermore, they reveal that such increases are more significant for states characterized by high interparty political competition. While theoretical limitations preclude a definitive explanation for these results, the evidence is consistent with a view of state political markets where incumbent parties manipulate public policy so as to enhance the probability of success in pending elections. This insight is significant in that it suggests a relationship between public policy decisions and election cycles in a context heretofore unexplored.