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The article discusses the study on the importance of the attitudes and perceptions of health service providers for the implementation and delivery of community health services. The study collected data from three sources including a national sample of short term acute hospitals and health departments, from 25 county and four city health jurisdictions and information from administrators of planning agencies serving New York organizations. The findings of the study states that the limited knowledge that many health workers and laymen appear to have about certain health service needs and the operation of the health system and the different perceptions of respondents about the nature and scope of the responsibilities that should be assumed by various health organizations and support agencies.

The article discusses the role of medical care in a changing social system. The concern about the rising cost of medical care and the growing importance of that care makes it necessary to examine the role medical care plays in a complex society. The apparent cause of increasing medical expenses is linked to the increasing demand of better care by the people for their personal well-being. There are a number of forces operating together as medical care costs increase. First, there is the general level of advancement and complexity of the social system itself. Heart lung machines, renal dialysis, and pacemakers are artifacts of highly developed technologies. Advanced technology is the necessary cause of an effective medical care system. At the same time, the increasing complexity of the social system provides the sufficient cause for an increased allocation of resources to medical care. As societies become more complex, they devote a greater proportion of their resources to medical care, but the medical care of all members of a society is not affected equally.

This paper investigates the relationship between attributes of thirty-two innovative health services and their level of implementation in a national sample of hospitals and health departments. It was found that services implemented in hospitals are primarily characterized by high payoff, a low rate of cost recovery, and low social approval. For health department services perceived primarily as having high divisibility, a high association with the preventive orientation of the department, and a relatively low payoff had a high level of implementation. The respective attribute patterns accounted for 58 per cent of the variance in the implementation of health services in hospitals and 50 per cent of the variance in health departments. [ABSTRACT FROM AUTHOR]

This article describes the context and examines factors influencing the quality of primary health care delivery and management in Ghana, West Africa. It describes the potential of continuous quality improvement as a management philosophy and tool to improve the quality of primary health care delivery and management in Ghana. It compares the Ghanaian context in which the use of continuous quality improvement in health care is new and untried with the developed country context (mainly the U.S.), where continuous quality improvement has a relatively long history of use in health care and is a requirement for the accreditation of health institutions. Finally, the article discusses the steps that have to be taken to translate continuous quality improvement from a theoretical management concept to improve quality of care to an actual managerial intervention in Ghana. In conclusion, continuous quality improvement is shown to be a potential viable approach to improving quality of care in the Ghanaian context and merits further investigation. [ABSTRACT FROM AUTHOR]