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These findings suggest that even when costs are totally reimbursed, most children in need of care do not receive it; the greater the need of care, the lower the likelihood of getting it. The deprived people and immigrants frequently inhabiting the Parisian suburbs seem to experience cultural, financial, linguistic, and administrative barriers to care, which impede uptake and which must be changed if these children are to enjoy improved dental health.

To understand why some achievable benefits are not achieved it is necessary to evaluate the varying performance of health services according to the social origin of the users.

The impact of a multi-dimensional geriatric assessment (MDGA) programme on the reorientation of the elderly person at discharge is described. One hundred and six elderly persons from a hospital catchment area identified for its poor level of social services, poor living conditions and high prevalence of dependency were allocated to either an experimental or control group. The experimental group was given the multi-dimensional assessment in the first three days of admission while the control group was subject to the usual hospital procedures. The study shows that the provision to the medical staff of easily obtained information relating to the individual's level of dependency and living conditions, in conjunction with recommendations for possible post-discharge placement, significantly reduced prolongation of stay due to non-medical reasons, albeit without a measurable impact on the whole duration of hospital stay.

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