When the quality of a good varies, quantity in physical units may be a very misleading measure of total consumption. In this paper it is argued that differences in quality are a distinguishing feature of the market for physicians' services. We develop a model to analyze properties of demand functions for the quantity and quality of physicians' services and apply the model to study the demand for pediatric care-physicians' services rendered to children. The theoretical model of quantity-quality substitution provides a framework for demand analysis whenever the market for a good is distinguished by a quality component. When the quality of a good varies, quantity in physical units may be a very misleading measure of total consumption. This point long has been This is a condensed version of Goldman and Grossman (1976). The longer version is available on request.

The aim of this paper is to assess the impact of the Community Health Center (CHC) on health levels in the U.S. Using infant mortality as the underlying health indicator, a time series of large counties as the data set, and multivariate regression techniques, we investigate the extent to which the presence of a program in a county affects future mortality. We find that CHCs have negative and statistically significant impacts on white and black infant mortality rates. The centers have larger effects on black infant mortality than on white infant mortality. The reduction in the black infant mortality rate between 1970 and 1978 due to the CHC system amounts to one death per thousand live births or approximately 12 percent of the observed decline. This result is particularly striking in light of the wellknown higher infant mortality rate of blacks. A reduction in the excess mortality rate of black babies has been dentf1ed as a goal of public health policy for a number of years. Our results suggest that community health centers have the potential to make a substantial contribution to the achievement of this goal.

The aim of this paper is to examine the determinants of interest rates on tax-exempt hospital bonds. The results highlight the potential and actual roles of Federal and state policy in the determination of these rates. The shift to a Prospective Payment System under Medicare has subsidized the borrowing costs of some hospitals at the expense of others. The selection of underwriters by negotiation rather than by competitive bidding results in higher interest rates. The Federal tax act of 1986 raised the cost of hospital debt by encouraging bond issues to contain call features.

This paper contains estimates of the impacts of air pollutants on race-specific neonatal mortality rates based on data for heavily popu-