Consumer-sponsored prepaid group practice: restructuring the health care system

The traditional separation of health care delivery and financing systems is breaking down as various new types of health care facilities are established and as payment continues to be a major concern. Group Health Cooperative of Puget Sound (GHC) was organized as a prepaid group practice system responsive to consumers. Costs, methods of payment and delivery of care are interrelated and are all influenced by consumer ownership. GHC has been refining its benefit programs since 1945. Strategies for controlling use and costs focus on improved provider management and on flexibility. This article explains how the structure of GHC benefits the consumer.     

Child witness statement quality

Use of general questions in child witness interviews often limits the completeness of young children's recall. In this study experienced professionals interviewed 5–6 year olds and 8–9 year olds “as they would normally” about live events witnessed by the children. Interviewers' spontaneous use of general and specific questions was assessed, as were the effects of these question types on the children's recall. A main result was that the younger children would frequently fail to answer general questions but would then provide information relevant to these same questions later in the interview. Use of specific questions in these relatively naturalistic interviews did not necessarily improve the overall completeness of younger children's recall, contrary to some previous findings, although, in line with previous findings, such questioning reduced overall accuracy rates. These results highlighted the scale of the problem of “omission errors” in young children's recall. Implications for the use of general questions by professionals who interview child witnesses are discussed.     

Feasibility and Acceptability of an Impact of Crime Group Intervention with Jail Inmates

The current study evaluated the feasibility and acceptability of a manualized Impact of Crime (IOC) group intervention implemented with male inmates (N = 108) at a county jail. Facilitator adherence to the intervention and participant attendance, homework completion, and feedback were assessed. On average facilitators covered 93.7% of each manual topic. Victim speaker recruitment was a challenge—43.5% of relevant sessions lacked victim speakers. Findings suggested significant participant engagement—67.3% attended at least 75% of sessions and 93.3% of homework assignments were submitted on time. Overall, participants indicated satisfaction with the intervention. Successful strategies, challenges, and potential enhancements are discussed.