HEALTH ECONOMICS, VOL. 5: 375-379 (1996)

STUDENT CORNER

The student corner publishes contributions on all aspects of education and training in health economics and related disciplines. The content of the section will develop over time but initially it will cover three main areas:

0 A digest of information 0 Short peer-reviewed papers whose content is pedagogical rather than reporting original research. 0 Major commissioned surveys of key areas of the literature written for the benefit of students of health

For more information, or to discuss possible contributions, please contact Andrew Jones (tel: 44-1904- 433766, fax: 44-1904-433759, e-mail: amjl@york.ac.uk). Please submit announcements and contributions to: Health Economics, Student Comer, Centre for Health Economics, University of York, York, YO1 5DD, U.K.

economics.

FINDING HEALTH RESOURCES ON THE INTERNET-THE DEPARTURE LOUNGE

JAMES MASON Centre for Health Economics, University of York, Heslington, York YO1 SDD, UK

Tel: 01904 433640; fax: 01 904 433644, email: jmm7@york.ac.uk

INTRODUCTION

This is not another one of those articles telling you how to get on to, or use, the Internet. A recent series in the British Medical Journal covers the basics.’-’ Neither can this claim to be an impartial review of useful sources of information for health economists and those in allied disciplines. Rather, I want to point you to the Departure Lounge: a World Wide Web (WWW) page which contains a large collection of links to places that may interest you in the course of your research. The page illustrates the type of resources that are available through the Internet: you can find hospitals, jour- nals, government departments, health authorities and national associations both in Britain and abroad, as well as on-line databases and discussion groups.

THE DEPARTURE LOUNGE

You can access the Departure Lounge from the WWW Centre for Health Economics Home Page at the University of York (http://www.york.ac.uk/ inst/che/welcome.htm). Pages can be satisfac- torily viewed using either graphical (e.g. Netscape) or text-based (e.g. Lynx) browsers. The information provided is regularly updated and you are encouraged to report new or out-of-date links.

The Departure Lounge (see Appendix) is divided into categories for convenience. For example, in the University of York ... category, links provide information about the work of each group or department at York, some of the key personnel and contact addresses.

In the UK Government and National Associations . .. category, the UK Government

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link will take you to an index of all central and local government WWW sites available, although you may wish to use the short-cut links to the Department of Health or the HMSO listed beneath. Similarly, the US Federal Government link in the international category is a useful front door to many official web destinations in the United States.

Journals ... are becoming increasingly inter- ested in electronic publishing as the capabilities of the Internet develop. Health Economics is con- sidering publishing peer-reviewed short papers on the Internet.6 This is to aid rapid dissemination of timely information in the fields of economic evaluation of organizations, financing mechanisms and health care technologies. The British Medical Journal and the Journal of the Americati Medical Association are now on-line with the texts of some editorials and abstracts available. However, com- plete full texts with graphics still appear some way off and, as with the BMJ, currently only selections of text are available.’

Some UK health authorities ... and UK hospitals ... now provide information on the Net to patients, medical students and doctors. This is a new mode of communicating information to the public and consistent with the obligations of the Patient’s Charter.* According to the Charter, FHSAs should provide information about local medical services, to include information on perfor- mance set against quality standards; this is being further developed to include the handling of comments and complaints. An interesting line of enquiry for future research would be to consider the adequacy of information provided on the Internet against set quality criteria. Also of concern is accessibility: wealthy and well educated patients are more likely to have access to, and utilize, the facilities available. As the Internet’s role as a form of communication develops it may increasingly be seen as a merit good, intrinsically valuable, with access becoming an equity issue much the same as health care provision itself. In this vein, it is interesting to see public libraries increasingly providing Internet access.

Health Related Links ... provides pointers to other university groups and general resources, and Other Lists of Links ... allows you to access other compilations, often with a greater international emphasis.

There are (to my knowledge) three ways of getting involved in Discussion Groups . . . on the Internet. First, there are Internet news groups, for example the alt.health and misc.health categories

(entering news:?health in some WWW browser will list all related groups). These are open discus- sion groups accessible through the WWW, where anyone can read contributions and mail new postings or comments. Participation is easiest with recent software which allows you to post directly without loading a separate email program.

Second, there are email-based discussion groups: these require you to subscribe to a mailing list before you receive postings to the group. Postings are not accessible from the WWW, but come direct to your email address. An example is the health-econeval mailing list provided by MAILBASE which claims to be the UK’s major electronic mailing list service. Membership of some mailing lists is closed, requiring applicants to meet entrance criteria, such as the Health Econ- omist’s Study Group (hesg@mailbase.ac. uk). There are many email discussion groups pertinent to economics and its subspecialities: these have been documented by Goffe’ and Krichel and Wichmann. l o Contributors (and their respective contributions) to email-based discussions are potentially subject to vetting or censorship. No commercial use or advertising is permitted with academic mailing lists.

The third mode of interaction is through a ‘talker’, Multi-User Domain (MUD) or Internet Relay Chat (IRC) program. Users log in to a remote facilitating computer through the Telnet system. Each user’s keyboard entries are relayed and become visible to all other users, hence real- time conversation is possible. Simple commands usually make it possible to ‘walk’ into an adjoining ‘room’ to hold a private conversation. No talkers dedicated to the discussion of health-related issues have come to my attention but I guess it is only time. These may develop as on-line help facilities for NHS information providers and are the forer- unner of ‘ faces-on-screen’ visual real-time conversation.

The Internet is seen by many as having great potential for sharing information, reviews, reports and data. Online Databases ... points to the ESRC Data Archive which catalogs (they claim) the largest collection of accessible data for the social sciences and humanities in the UK. Datasets can be identified, ordered and supplied in various media including direct electronic transfer. Links are also provided to the two on-line NHS Centre for Reviews and Dissemination databases: the Data- base of Abstracts of Reviews of Effectiveness (DARE), and the N H S Economic Evaluation

STUDENT CORNER 377 Database NEED. Access to these is by the Telnet system. If your browser does not support Telnet, then you will need to use a Telnet program to log in to: nhscrd.york.ac.uk. The UK Outcomes Clearing House at the Nuffield Institute for Health in Leeds has also recently launched an online database.

You can find further sources of information about any topic, on the Internet, using a search engine such as Lycos or the World-Wide-Web Worm. These are special programs that continu- ously search the Internet, cataloging findings and which hold a huge on-line database of links. Simple or structured searches can be submitted and findings are returned directly to your browser. Clicking on the surfer icon at the end of the Depar- ture Lounge page will take you to a list of the main search programs. Saving useful links as book- marks, as you search, will enable you to create your own Departure Lounge.

SUMMARY

As with all other areas of research, the influence of the Internet on health economics will continue to grow. The availability of information is cen- tral to the UK health reforms and plans are afoot to create an NHS network." Harnessing the power of the Net has become a basic research skill. This involves information and data cap- ture, work sharing and communication as well as dissemination of our own work findings. You might optimistically regard the Internet as a system of arteries and arterioles through which oxygen of information may flow effectively to those who need it. However, users are some- times frustrated by slow access, poorly indexed information and lots of noise: successful use sometimes seems reliant on serendipity. The Departure Lounge will try to keep you up to speed with developments.

APPENDIX THE DEPARTURE LOUNGE

Welcome! This page provides passage to links relating to health economics, health technology assessment, and health services research as well as hospital links. All relevant W3 pages at the Uni- versity of York are shown here. If you know of any good links, or find one of the links below has changed, then please write.

University of York ... 0 Centre for Health Economics (CHE). 0 Cochrane Collaboration on Effective Profes-

sional Practice (CCEPP). 0 Department of Health Sciences. 0 Economics Department. 0 Institute for Research in the Social Sciences

0 NHS Centre for Reviews & Dissemination IIRSS).

ICRD). - see On-line Databases.. .

0 Social Policy Research Unit (SPRU). 0 York Health Economics Consortium (YHEC)

UK Government and National Associations ... 0 National Association of Commissioning GPs 0 National Association of Health Authorities and

Trusts (NAHAT). - see Advertisements.. .

Services

- Deuartment of Health - HMSO (Her Maiesty's Stationary Office)

0 Northern Ireland Health & Personal Social

0 UKGovernment

International, Government and National Associations . . . 0 Health Canada 0 Swedish Council on Technolo_pv Assessment in

0 US Congressional Office of Technolonv Health Care CSBU)

Assessment 0 US Department of Health and Human Service 0 US Federal Government WWW

United States Public Health Services 0 US. White House Information 0 World Health OrFanisation Home Page

Journals . .. 0 British Medical Journal (BMJ) 0 Health Economics 0 Journal of Health Economics 0 Journal of the American Medical Association

(JAMA) 0 Pharmacoeconomics 0 Svname Medical Publications

UK Health Authorities ... 0 Dorset Health Commission 0 GwvneddEWSA 0 Isle of Wight Health Commission

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UK Hospitals . . . 0 Addenbrooke’s Hospital via Cambridge 0 Nuffield Institute for Health, University of

0 Brighton Health Care NHS Trust - see On-line Databases 0 British Hernia Center, London 0 Central Middlesex Hospital NHS Trust 0 Cerediaion and Midwales NHS Trust 0 Personal Social Services Research Unit 0 Christie Cancer Research Centre, Manchester 0 Guy’s and St. Thomas’ Hospital (United Medi-

cal and Dental Schools). London 0 US National Library of Medicine, Bethesda 0 Harefield Hospital NHS Trust 0 John Radcliffe Hospital via Oxford University 0 Kinps College Hospital [School of Medicine

and Dentistrv), London 0 Livemool School of Tropical Medicine 0 WWW Virtual Library ( Medicine and 0 North Durham Acute NHS Trust

UK Hospitals (continued) ... Other Lists of Links ... 0 North Lakeland Healthcare NHS Trust 0 EINet Galaxy Medical List 0 Nottingham City Hosuital NHS Trust 0 GNN Whole Internet Catalog Medical List 0 Nottingham Community Health NHS 0 Health Economics links, University of Bayreuth

0 The Health Economics, Medical and Pharmacy 0 Pinderfields Hospital, Wakefield Resource Page 0 Royal Brompton Hospital, London 0 Health-related World-Wide Web servers,

0 Roval Marsden Hospital, London 0 Lee Hancock HSR links, University of Kansas 0 Universitv of Newcastle Medical & Dental Medical Center

0 Nottingham School of Public Health, England

University Leeds, England

0 NURSE, University of Warwick, England 0 Oncolink

(PSSRU), University of Kent, England 0 RAND

MD, USA 0 Virtual Hospital 0 WebPath: Internet Pathology Laboratory 0 WHO Health Economics

Bioscience)

Trust-Health Shop

0 Royal Free Hospital, London WHO

Resources on the Internet 0 Pollanen’s Cyberland Medical Links 0 Whole Internet catalog (Health and Medicine) 0 Yahoo Medicine List

Discussion Groups . . . 0 Index of discussion proups (MAILBASE)

Hospitals Abroad.. . 0 Hospitals on the Web (International) 0 Medical Schools on the Web (International) 0 Saint JoseDh’s Health Centre, London: Ontario.

Canada 0 Econometric research applied to health (MAILB ASE )

0 Issues concerning the financing and evaluation of health care (FINAN-HC) - use this link to send email to request details.

Health Related Links . . . 0 Agency for Health Care Policy and Research,

0 Centre for Evidence Based Medicine, Oxford, 0 Using economic evaluation in systematic

0 Cochrane Collaboration, McMaster, Canada 0 HealthNet Demonstration Project 0 Health Economics Research Group (HERG),

Brunel, England 0 NHS Centre for Reviews & Dissemination 0 Institute for Fiscal Studies. England (CRD). 0 Interactive Medical Student Lounge - telnet: DARE-Database of Abstracts of 0 Intergovernmental Health Policy Proiect , Reviews of Effectiveness

- telnet: NEED-NHS Economic Evaluation 0 International Health Economics Association Database

0 Irish Medical Home Page 0 Outcomes Activities Database 0 Health Information Research Unit (HIRU), -Provided by the UK Outcomes Clearing

House at the Nuffield Institute for Health, Leeds

USA

England reviews (MAILBASE)

Online Databases ... 0 The ESRC Data Archive

George Washington University, USA

(iHEA) login: crduser, password: crduser

McMaster University, Canada

STUDENT CORNER 379 REFERENCES

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7. Delamothe, T. BUT on the Internet. British Medical Journal 1995; 310: 1343-1344.

8. The Department of Health and the Central m c e of Information. The Patients Charter and Family Doctor Services. London: The Department of Health and the Central Office of Information, March 1993.

9. Goffe, W. L. Computer network resources for economists. Journal of Economic Perspectives

10. Krichel, T. and Wichmann, T. In- primer for econ-

11. Keen, J. Should the National Health Service have an information strategy? Public Administration

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omist~. T h e E ~ ~ n o m i ~ J W 1994,104: 14%-1523.

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