Using concepts of implementation analysis, this paper examines potential outcomes of the PSRO program, the federal government's effort to assure high quality and efficiency in health services. Support for PSROs at the local level, among professionals and the public, is uneven, suggesting implementation problems for recently or yet-to-be established PSROs. Mutual adaptation of program and local institution depends on the degree to which local needs are given emphasis. Continued willingness by the federal government to accommodate local problems and objectives is required. Evaluation procedures for PSROs should be developed now as an integral part of the on-going program. Whether the PSRO program can overcome mobilization and operationalization problems remains to be seen. Problems as outlined will influence program implementation at all stages and early cognizance should be taken of them. The rush to establish the PSRO system may have deprived implementation issues of the attention they warrant. 21 pp. Ref.
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