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The compliance of 346 young diabetics aged 13-17 years with health regimens is analysed in the framework of a MIMIC (multiple indicators, multiple causes) model. The data were compiled by means of a questionnaire on compliance, conditions for compliance, the meaning attached to treatment and the impact of the disease, and the model constructed using the LISREL VII programme, treating compliance as an unobserved variable formulated in terms of observed causes (x-variables) and observed indicators (y-variables). The resulting solutions are entirely satisfactory. The goodness-of-fit index is 0.983, the root mean square residual 0.058 and the chi-squared statistic 43.35 (P < 0.001). The values for the individual parameters in the model are also shown to be reliable and valid. The model shows compliance to be indicated by self-care behaviour, responsibility for treatment, intention to pursue the treatment and collaboration with the physician, and to be greatly determined by motivation, experience of the results of treatment and having the energy and will-power to pursue the treatment and, to a lesser extent, by a sense of normality and fear.

Nimodipine is cost-effective. Therefore, its use in the management of patients with SAH seems economically justified because it increases patient life years at very low incremental cost.

Purpose: To get an informative and detailed picture of the resource utilization Key words: Radiology, economic in a radiology department in order to support its pricing and management.issues; cost, cost accounting; cost Material and Methods: A system based mainly on the theoretical foundations analysis, organizational management. of activity-based costing (ABC) was designed, tested and compared with conventional costing. The study was performed at the Pediatric Unit of the Depart-Correspondence: Jouni M. J. Laurila, ment of Radiology, Oulu University Hospital. The material consisted of all the Department of Radiology, Porvoo 7,452 radiological procedures done in the unit during the first half of 1994, Hospital, Sairaalantie 1, when both methods of costing where in use. Detailed cost data were obtained FIN-06 200 Porvoo, Finland. from the hospital financial and personnel systems and then related to activity FAX π58 19 54 82 267. data captured in the radiology information system.Results: The allocation of overhead costs was greatly reduced by the intro-Accepted for publication 22 October duction of ABC compared to conventional costing. The overhead cost as a 1999. percentage of total costs dropped to one-fourth of total costs, from 57% to 16%. The change of unit costs of radiological procedures varied from ª42% to π82%.Conclusion: Costing is much more detailed and precise, and the percentage of unspecified allocated overhead costs diminishes drastically when ABC is used. The new information enhances effective departmental management, as the whole process of radiological procedures is identifiable by single activities, amenable to corrective actions and process improvement.