A conceptual framework was presented for describing, comparing, and analyzing the structure of health care models serving adults with mental retardation/developmental disabilities (MR/DD). This framework, which was drawn from Donabedian's (1980) work on the components of quality of health care—structure, process, and outcome—provides a basis for comparing health service models according to three key domains: measures of access, comprehensiveness, and cost. We used this framework to describe three existing programs that use different models to serve this population.

This research was supported in part through a grant from the Robert Wood Johnson Foundation and the Developmental Disabilities Council of New Jersey. An earlier version was presented at the annual meeting of the American Association on Mental Retardation, Washington, DC, May 1991. The authors thank Lidia Dengelegi and Steve Crystal of Rutgers University, Institute for Health, Health Policy, and Aging Research; Cathy Lorber of Schwab at the Center; Deborah Spitalnik and Robert Like of the Family Practice Center; and Steven Krivit of the Santa Barbara Health Care Initiative.

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