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发表于 2010-1-22 13:57
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Summary0 O* r5 y( H$ ^$ l- Z' b
Social attention has been increasingly paid to health care systems varied in effectiveness and
* A1 R& z6 u* tefficiency. This ** addresses the assessment and prediction of health care system. First and8 m/ \0 L4 c) n; g/ ]4 l
foremost, a metrics list is established and refined for further assessment. Secondly, model tests are4 d* f$ b6 Y# W: y
conducted between countries. Thirdly, a predictive model based on the relationship between. e/ x9 x9 K$ z4 Z$ E: R7 M1 J: \
changes and performance is proposed for restructure of the United States health system.
+ d4 ] t, B9 i9 I; wUnder the guidance of WHO Health System Performance Framework, we gain an insight of the$ B+ h( v' l) H# m& f
problem. Focusing on the outcomes, health, responsiveness and financial protection, we devise
) A: A/ k% }9 X# u @5 Fmetrics to build an index system for evaluat ion. Lists which describe each metric are presented7 J" X _# f8 x
afterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried
$ M$ K' U$ N8 w, h3 b$ F5 Sout, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P
2 T0 B v4 H! }+ i3 K+ R8 S9 mhealth care system. With these metrics, we can compare the relative quality of systems. After a
1 Z6 q" L- |1 y0 u0 othorough search of data sources, we refine the metrics list based on data availability, and also/ ?, R; Q3 M1 D9 ]5 n
present the estimating and obtaining approaches.
]; o! @3 @6 ^, l* HFor the purpose of international comparison, Principal Components Analysis is applied to choose
; n v7 p+ b! B' j( J3 N8 [the most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,
; A1 i- }$ J' Z1 o* w% simmunization coverage among 1-years-olds and fairness of financial contribution are finally- l! z( V; O' @6 m" I
selected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test) k5 p e( R4 n" f6 y9 ]0 w
results between the United States and two other countries are showed below:
6 f' O8 D# e$ B# F S9 a( nInvestigating the discrepancy between results, we attribute the cause to the differences in devise of
0 Q7 E* L8 e6 G- e% xmetrics and weights in CEM.+ m2 r% @5 t+ A; t" `2 j
Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is
5 e" X* ?( K: ~. |: x9 b7 k; hintroduced to find the relationship between the major contributing input factors and outcomes.
% `# u- h a8 ]Further more, after analyzing the variations of functions, possible policy changes to improve are! c4 k' q, o ]3 s% S5 c8 D4 L
recommended, including strengthening primary care system and conducting a single payer system.! L' a) X, S8 M2 e* ]* y3 n7 S: m
Finally, the strength and weakness of our models are summarized, as well as two urgent aspects for0 o8 S* G+ y) L" N! N! Z
future work. The main achievements and contributions of this ** are concluded in the end. |
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