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发表于 2010-1-22 13:57
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Summary
4 R2 @" z/ l. I8 ]( z7 V( _Social attention has been increasingly paid to health care systems varied in effectiveness and; e; r% ?3 l( r
efficiency. This ** addresses the assessment and prediction of health care system. First and
+ V5 I) Q* ?$ d2 c; ^- J* Dforemost, a metrics list is established and refined for further assessment. Secondly, model tests are# j T2 Z5 A j' m
conducted between countries. Thirdly, a predictive model based on the relationship between C* w' m- g3 G" m0 c. q) r
changes and performance is proposed for restructure of the United States health system.4 M; Y9 n2 c7 p" D" `/ |/ K, b
Under the guidance of WHO Health System Performance Framework, we gain an insight of the! d6 I e% N9 I9 f# u
problem. Focusing on the outcomes, health, responsiveness and financial protection, we devise
d5 Y/ r2 q1 A/ }5 E, k2 X0 Ometrics to build an index system for evaluat ion. Lists which describe each metric are presented
0 }6 Z! ^7 Z$ ` s7 t) [3 Rafterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried+ O: L( W5 y8 m4 I$ }
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P" y B, B3 u/ H; J
health care system. With these metrics, we can compare the relative quality of systems. After a
' k% [7 D$ K" Y/ T+ Y: Pthorough search of data sources, we refine the metrics list based on data availability, and also
: [$ o9 x0 d7 d, o9 Cpresent the estimating and obtaining approaches.
" N2 Z; M1 L: E5 l! O0 ~For the purpose of international comparison, Principal Components Analysis is applied to choose) Y9 N W; W) S1 j6 f
the most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,
% z8 k3 z* S; C& bimmunization coverage among 1-years-olds and fairness of financial contribution are finally
+ a9 o. S. g i# Q2 nselected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test g8 K9 |( c0 J$ Q- G
results between the United States and two other countries are showed below:) \$ |, j: H& i: k; ^- q: o
Investigating the discrepancy between results, we attribute the cause to the differences in devise of: u; {0 `$ L: s# P _
metrics and weights in CEM.
8 m, E% A4 R5 N. y, c$ wThen we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is3 ]$ O7 V! X' @# `: ]
introduced to find the relationship between the major contributing input factors and outcomes.
5 [+ D2 i5 I- ~) _- d1 ?/ F1 FFurther more, after analyzing the variations of functions, possible policy changes to improve are4 k& {; \% _' O3 J1 }$ W
recommended, including strengthening primary care system and conducting a single payer system.# `6 i8 n% O9 [ i5 G B2 y: L" `
Finally, the strength and weakness of our models are summarized, as well as two urgent aspects for x% }. c0 B/ _) L
future work. The main achievements and contributions of this ** are concluded in the end. |
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