Abstract:

A broadly defined "marketing" approach to accountability in service delivery is proposed, with particular attention to consumerism as it underlies the idea of accountability in the field of aging. Five policy strategies, aimed at strengthening consumerism, are identified: (1) use of a mediator (a drawback is his lack of enforcement power); (2) competitive market between agencies to ensure that they meet client needs (however, the fact that agencies work largely on referral seems to contradict this measure); (3) policy reviews to strengthen & expand regulations; (4) community participation to raise the power of those served, where it is assumed that patients have the knowledge & stamina to challenge the institutions; & (5) market enlargement, with more individualized services, also requiring more expense. Since it is evident that all five have problem points, it is suggested that any policy strategy be implemented slowly & in steps.