The Fund supports several networks of state health policymakers to help identify, inspire, and inform policy leaders.
The Fund identifies and shares policy ideas and analysis on topics important to state health policymakers, particularly on issues related to state leadership, primary care, aging, and total costs of care.
Keep up with news and updates from the Milbank Memorial Fund. And read the latest blogs from our thought leaders, including Fund President Christopher F. Koller.
The Fund publishes The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to health policy leaders.
The Milbank Memorial Fund is an endowed operating foundation that publishes The Milbank Quarterly, commissions projects, and convenes state health policy decision makers on issues they identify as important to population health.
UM WHAT? March 1994
David L. Shern
Nancy Z. Wilson
Anita Saranga Coen
Diane C. Patrick
David A. Bartsch
Back to The Milbank Quarterly
The outcomes of a reform of the Denver mental health system, cosponsored by the state and the RWJF, are contrasted with changes in a comparison area of the state. The study examines the structural characteristics of the mental health system, staff attitudes and satisfaction, and client-reported services and outcome. Results indicate that, in Denver, structural changes, the introduction of new services, and an intervening financial crisis increased worker dissatisfaction. Client reports documented parallel changes in the following variables: continuity of care, unmet need for case management services, frequency of symptoms, and satisfaction with services. The reform had no impact, however, on most quality-of-life indicators. The possibly adverse consequences of centralizing the system and the indirect influences of system integration on quality of life are discussed.
Author(s): David L. Shern; Nancy Z. Wilson; Anita Saranga Coen; Diane C. Patrick; Mark Foster; David A. Bartsch; Jean Demmler
Download the Article
Read on JSTOR
Volume 72, Issue 1 (pages 123–148) Published in 1994
Get the Latest from the Milbank Memorial Fund
The Milbank Quarterly’s multidisciplinary approach and commitment to applying the best empirical research to practical policymaking offers in-depth assessments of the social, economic, historical, legal, and ethical dimensions of health and health care policy.