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发表于 2010-1-22 13:57
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Summary
6 G7 C: r1 t9 G- {( m4 OSocial attention has been increasingly paid to health care systems varied in effectiveness and' R, S0 o R5 m; u5 z1 ?- d
efficiency. This ** addresses the assessment and prediction of health care system. First and
9 ?! W$ w7 I0 H/ qforemost, a metrics list is established and refined for further assessment. Secondly, model tests are! A* p( O; T m8 Q
conducted between countries. Thirdly, a predictive model based on the relationship between6 ?* Y9 v4 m5 @3 G
changes and performance is proposed for restructure of the United States health system.
8 D) O/ U9 t9 xUnder the guidance of WHO Health System Performance Framework, we gain an insight of the, O2 X, S6 x# T4 B
problem. Focusing on the outcomes, health, responsiveness and financial protection, we devise
% G- W3 j1 B, |) o4 b& }0 fmetrics to build an index system for evaluat ion. Lists which describe each metric are presented
" `# R3 D( ] ]3 ^afterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried3 [. h0 o) @. n+ u0 f* g6 h% D- a @
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P% ]9 B/ L3 ^0 V# V# z1 n
health care system. With these metrics, we can compare the relative quality of systems. After a$ X2 W: d1 z* x/ }! I/ p R
thorough search of data sources, we refine the metrics list based on data availability, and also( t$ n* L* C( t! W* Q$ Q8 c
present the estimating and obtaining approaches.: r' T( e/ k3 b5 Q9 c
For the purpose of international comparison, Principal Components Analysis is applied to choose5 O) G5 T% K. }
the most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,) R( {! B0 h8 w9 O) y& p
immunization coverage among 1-years-olds and fairness of financial contribution are finally
: f/ s! ~ s* ?& n' gselected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test& d7 _: j$ {8 t6 O
results between the United States and two other countries are showed below:+ c. L& [1 \9 B2 v4 P8 {" y
Investigating the discrepancy between results, we attribute the cause to the differences in devise of4 h7 n& y; M0 X7 ]! H6 s3 V* ?0 ^5 w
metrics and weights in CEM.. A! b* M2 m% D l' U5 N' r" @& i
Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is
& T( P! E9 ^! h" R _; k' Gintroduced to find the relationship between the major contributing input factors and outcomes.! V, Y8 ]# a' b! _
Further more, after analyzing the variations of functions, possible policy changes to improve are
/ f R; S6 l' |- Z) V' frecommended, including strengthening primary care system and conducting a single payer system.
+ u+ e" J& C) i1 A& R: TFinally, the strength and weakness of our models are summarized, as well as two urgent aspects for" D0 a( c4 v( b3 s; U" C: }9 F
future work. The main achievements and contributions of this ** are concluded in the end. |
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