No abstract

A total of 7706 persons are participating in a controlled trial of alternative health-insurance policies. Interim results indicate that persons fully covered for medical services spend about 50 per cent more than do similar persons with income-related catastrophe insurance. Full coverage leads to more people using services and to more services per user. Both ambulatory services and hospital admissions increase. Once patients are admitted to the hospital, however, expenditures per admission do not differ significantly among the experimental insurance plans. In addition, hospital admissions for children do not vary by plan. The income-related cost sharing in the experimental plans affects expenditure by different income groups similarly, but adults' total expenditure varies more than children's. Sufficient data are not available on whether higher use by persons with free care reflects overuse, or whether lower use by those with income-related catastrophe coverage reflects underuse. Both may well be true.

The effects of five kinds of questioning, two interpersonal atmospheres of interviewing, and five levels of item difficulty on the accuracy and completeness of testimony about a short film were tested in a legal interrogation setting. Subjects enjoyed the supportive style of interviewing more than the challenging style, but atmosphere had no important effect on recall performance. The type of questioning produced almost no differences in affective or cognitive reactions. However, as the specificity of questions increased, so did the completeness of testimony. Accuracy of testimony showed slight decreases for more specific questions. The trade‐off between accuracy and completeness was mediated by item difficulty. It was very pronounced for items of high difficulty and not apparent for items of low difficulty. Leading questions by themselves or in interaction with atmosphere did not produce special distortions in accuracy.

and KENTMARQUIS United States Census Bureau, Washington, D.C.QUAID (question-understanding aid) is a software tool that assists survey methodologists, social scientists, and designers of questionnaires in improving the wording, syntax, and semantics of questions. The tool identifies potential problems that respondents might have in comprehending the meaning of questions on questionnaires. These problems can be scrutinized by researchers when they revise questions to improve question comprehension and, thereby, enhance the reliability and validity of answers. QUAID was designed to identify nine classes of problems, but only five of these problems are addressed in this article: unfamiliar technical term, vague or imprecise relative term, vague or ambiguous noun phrase, complex syntax, and working memory overload. Wecompared the output of QUAID with ratings of language experts who evaluated a corpus of questions on the five classes of problems. The corpus consisted of 505 questions on 11 surveys developed by the U.S. Census Bureau. Analyses of hit rates, false alarm rates, d' scores, recall scores, and precision scores revealed that QUAID was able to identify these five problems with questions, although improvements in QUAID's performance are anticipated in future research and development.A good surveyor questionnaire contains questions that elicit valid and reliable answers from respondents in a short amount oftime. One of the challenges to survey researchers and social scientists is to design questions that achieve these general objectives. Researchers in the field ofsurvey methodology have proposed models that dissect the many stages of question answering (Cannell, Miller,

Estimates of survey response bias and reliability are presented for six topics: receipt of welfare, income, alcohol use, drug use, criminal history, and embarrassing medical conditions. The estimates are derived from published full-design criterion validity studies. The common assumption that these characteristics are underreported is, in part, based on partial validity studies; the bias in estimating response parameters using partial designs is demonstrated. Evidence from the full-design studies suggests that the response biases for these topics center near zero but that the responses are unreliable or noisy. Implications for survey design and methodological research are considered.