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Medicaid, Medicare, and managed care reimbursement changes since the early 1980s have put added financial pressure on hospitals, increasing fears that private hospitals will decrease support for indigent care and that those hospitals that serve a disproportionately large indigent population may be forced to close. Wilson and Kizer (1997) use the term “safety net” to convey the notion that public health facilities, such as Veterans Affairs Medical Centers (VA), municipal hospitals, community health centers, and local public health departments, are providing uncompensated care for an increasing number of uninsured due to increasing cost pressures on private health facilities. Other research efforts also give evidence of increasing patient demand pressures on public health facilities in recent years (Lipson & Naierman, 1996). However, these efforts are often cross-sectional in design or limited to information from only one or a few health facilities in a metropolitan area (Baxter & Mechanic, 1997). As such, it is very difficult to measure fully the extent to which new legislation and private market changes have an effect on the public health “safety net” over time.This research considers the longitudinal relationship between the effect of Illinois implementation of the ICARE Medicaid reimbursement program, private hospital closings and the demand for VA inpatient services in a large metropolitan market in Chicago in the 1980s. Analysis is conducted with a combination of VA hospital discharge data, zip code level sociodemographic data from the U.S. Census, and data on hospital closures in the Chicago area between 1980 and 1990. The combined data allow for a longitudinal analysis of the tradeoffs between new state policy and hospitals over the provision of care for the indigent, including the effects of changes in reimbursement for Medicaid patients.

This paper aims to: design a comprehensive, review‐based and statistically tested corporate social responsibility disclosure (CSRD) index; measure item‐wise and theme‐wise the social performance of the top 82 companies in India; and investigate item‐wise and theme‐wise the variations in CSRD.

The paper presents an empirical study of CSRD in 2009‐2010, using content analysis, Cronbach's α, the Kolmogorov‐Smirnov and Shapiro‐Wilk tests of normality and a six point scale (0‐5), mean, skewness, kurtosis, and Levene's, Kruskal‐Wallis's and Mood's median tests for analysis and interpretation.

CSRD shows less satisfactory social performance, mainly narrative, and varies significantly among items and themes. Community development, with a mean score of 14.30, is the most disclosed theme, followed by HR, with a score of 11.20. The human element is the center of social performance in India. More than equal focus should be given to the environment and to emissions, which impact the greater interests of the world. Some burning global issues like water usage, alternative sources of energy, product safety and innovation have not received adequate attention.

The study offers ample scope for the further studies as each and every theme and item considered in the model/index requires individual focus to serve the future generations of mankind. Longitudinal/transnational studies in the area of CSR could be carried out to set the scene for further studies.

The paper recommends mandatory CSR norms leading to improved disclosure, the sharing of innovative knowledge, cost reductions and enhanced effectiveness in managing scarce resources.

The paper evaluates social performance in the economic, social, religious environment and highlights the emerging philanthropic attitude. The paper improves an existing model by incorporating an emerging dimension, i.e. “Emissions of carbon and other harmful gases”. The CSEEE index designed here is highly appropriate for developing economies like India. The paper measures CSRD using six‐point scales for the first time.

When Eugene O'Neill died, theatre critic Brooks Atkinson said of him, “A giant writer has dropped off the earth….He shook up the drama as well as audiences and helped to transform the theatre into an art seriously related to life.” (New York Times, 30 December 1953).