Abstract
A series of studies conducted in the same region found that programmatic, community-based health and social service interventions have a positive impact on client well-being. These proactive interventions, designed to address the full range of health and social needs, were usually provided at the same--or even lower--costs as uncoordinated, illness-focused care. The results of this series suggest that across-the-board health care reduction, at least in a system of national health insurance, will produce poorer results, at higher cost, for people with chronic conditions living in the community. Policy planners need more research that concentrates on comparisons of outcomes between and within different models of health and social service delivery. The studies should be designed to help them determine who benefits from different service configurations carried out within a range of policy environments at various costs.