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The Freeman Hospital in Newcastle upon Tyne is currently introducing case mix management under the auspices of the Department of Health's Resource Management Initiative. Like many other hospitals, particularly teaching institutions and large district general hospitals, Freeman is experiencing a trend towards complex cases arising either from tertiary referrals or technological advance. Successful management has increasingly meant understanding the relationship between the mix of cases treated in a specialty and the implications for resource allocation and expenditure. The biggest obstacle to this cohesive managerial approach has been the inadequacy of existing information systems which have tended to reinforce traditional managerial division between hospital departments and professional disciplines.

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