Performance indicators for primary care management in the NHS

There is increased emphasis on the measurement of performance in the NHS. Following the White Paper, additional high level indicators for measuring primary care performance at Health Authority level have been proposed by the NHS Executive. These include measures based on prescribing and on hospital admission rates for certain acute and chronic conditions. It is suggested that higher hospital admission rates for some conditions may indicate deficiencies in their management in primary care. In this paper we argue that there are difficulties with some of the proposed measures. The difficulties arise because individual single indicators are used to attempt to reflect more than one aspect of performance, may have large year to year variation and be subject to confounding. Using data on Family Health Services Authorities (FHSAs) from 1989/90 to 1994/5 we investigate how admission rates, and the ranking of FHSAs by admission rates, vary as socio-economic and secondary and primary care supply conditions are allowed for. The impact of socio-economic factors on admission rates and rankings is at least as large as the impact of the age and sex structure of FHSA populations. Allowing also for secondary care supply conditions has a smaller, but still noticeable, effect. We suggest that if admission rates are used as performance indicators in primary care they should be standardised for socio-economic and supply conditions, as well as for demographic factors. We also make a number of other suggestions for improving the indicators. Length: 34 pagesperformance indicators; policy implications

Complementary and alternative medicine in cancer: perspectives of patients and health professionals

Martin Keene investigated Complementary and Alternative Medicines in Oncology in Australia. He found that Health Professionals' limited knowledge negatively impacted discussions with their cancer patients to ensure the safe use of these therapies. This research provides valuable guidance on future education to facilitate integration of these therapies into hospital practice

The JBoss Integration Plug-in for IntelliJ IDEA, Part 4

Without an automated environment, deployment is often a painful process resulting in developers spending a great deal of time performing application deployment tasks. Most organizations strive for better management of this critical phase in the development cycle

The JBoss Integration Plug-in for IntelliJ IDEA, Part 3

This column builds upon our project by describing how to add a servlet for accessing the EJB methods implemented previously

The JBoss Integration Plug-in for IntelliJ IDEA, Part 2

This paper describes how to add a stateless session bean. It is stateless because we are not concerned with remembering values of attributes between successive calls from the client. This paper also demonstrates that our session bean can be either remote (i.e., a bean with a remote interface) or it can be local (a bean with a local interface)

The JBoss Integration Plug-in for IntelliJ IDEA, Part 1

The IntelliJ IDEA is an Integrated Development Environment (IDE) used for Java development. It is known for its strong refactoring capabilities. It is a closed-source, proprietary product, which is used in both educational and industrial settings. IntelliJ functionality is extended by a set of open APIs that third-party developers can use to integrate their solutions by the development of plug-ins