The quality of medical care is a potentially important determinant of health outcomes. Nevertheless, it remains an understudied area. The limited research that exists defines quality either on the basis of drug availability or facility characteristics, but little is known about how provider quality affects the provision of health care. The authors address this gap through a survey in Delhi with two related components. They evaluate "competence" (what providers know) through vignettes and practice (what providers do) through direct clinical observation. Overall quality as measured by the competence necessary to recognize and handle common and dangerous conditions is quite low, albeit with tremendous variation. While there is some correlation with simple observed characteristics, there is still an enormous amount of variation within such categories. Further, even when providers know what to do they often do not do it in practice. This appears to be true in both the public and private sectors though for very different, and systematic, reasons. In the public sector providers are more likely to commit errors of omission-they are less likely to exert effort compared with their private counterparts. In the private sector, providers are prone to errors of commission-they are more likely to behave according to the patient's expectations, resulting in the inappropriate use of medications, the overuse of antibiotics, and increased expenditures. This has important policy implications for our understanding of how market failures and failures of regulation in the health sector affect the poor.

Health and the use of health care. Risk, uncertainty, and the limits of insurability. The communitym interest in health care. Market fail- ure and the evolution of health care institutions: A historical pa- rable. Health care firms: Providers, practices, and people. Profes- sional practices: The not-only-for profit firms. Hospitals and relat- ed institutions: If not-for-profit then for what? Hospitals continued from teory to measurement. Health care for profit. Evaluating health care programs: Efficiency, effectiveness, and cost. Public invest- ment programs in prevention and research. Health manpower policy - leading the horses to water. Design or accident in health care policydato 900328 internt il

C is one of the most popular programming languages today. It is flexible, efficient and highly portable, and is used for writing many different kinds of programs, from compilers and assemblers to spreadsheets and games. This book is based on ANSI C - the recently adopted standard for the C language. It assumes familiarity with basic programming concepts such as variables, constants, iteration and looping, but covers all aspects of C. In general it is as much about learning programming skills as it is about mastering the art of coding programs in C. To this end the text contains a wealth of examples and exercises that foster and test the understanding of the concepts developed in each chapter. An outstanding feature of this book is a treatment of 'pointers'. The topic is presented in a clear, logical and reasoned manner that is easy to follow. Binary files and random access files are also treated in such a manner that the reader can easily become adept at using them. Anybody who wishes to get to grips with the art of programming in C will find this a most valuable book.

Reprint of the original, first published in 1875.