Over the eight month period covered by this grant, analyses are to be carried out based on data obtained in three projects that were started at various points during the five year funding of the Health Services Research and Development Center (HSR&DC) at the Johns Hopkins Medical Institutions and that ends January 31, 1976 (HS-00429). These projects are: (1) manpower configurations of physicians and non-physician providers of care and their effects on content and quality of care; (2) effectiveness of drug utilization review in altering prescribing practices; (3) health care behavior in a low-income community with OPD and HMO alternatives. These three projects were started as highly focused research investigations that bear on the broad, long-term objective of the Center. This is to assess the quality, utilization, and economics of primary care and how consumer, provider, management, and structural factors, as well as sources, methods, and levels of payment influence the results. In pursuing this objective, the Center has engaged in both methodological and substantive research of which these projects are examples, directed at well-defined issues, mainly in health care delivery sites where strong relationships are established and in the communities where they are located. Research has often been directed at identifying aspects of the delivery system, clinical practice or health care behavior of consumers to be considered for modification and later at measuring the outcome or change. Opportunities are also sought for well planned studies to determine the effect of "experiments in nature" which significant segments of the health care delivery system are experiencing through changes in structure, manpower utilization, and sources of funding.