Balancing policy objectives in long-term care.

The public policy objectives in long-term care--quality, availability, and cost containment--are promoted by different groups with conflicting but legitimate interests. The problem faced by the policymaker is to balance the economic and political consequences for patients, providers, and public funding agencies, and he often does this by partial achievement or selective nonachievement of the policy goals. A multidimensional objective function is described that permits calculation of the optimum extent to which conflicting goals can be achieved. The model allows simulation of the effects, on several simultaneous measures, of an administered change in some or all of the measures. The example given illustrates the complexity of the policymaker's problem and suggests a rational approach to dealing with it.