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发表于 2010-1-22 13:57
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Summary! Q+ }6 _7 c1 O
Social attention has been increasingly paid to health care systems varied in effectiveness and7 j8 m+ L9 P/ O
efficiency. This ** addresses the assessment and prediction of health care system. First and1 q* ? M: r! e* w
foremost, a metrics list is established and refined for further assessment. Secondly, model tests are/ i! x* {9 c" V3 m, x, S( b
conducted between countries. Thirdly, a predictive model based on the relationship between
3 F6 S: Q: j+ t. H& T! y8 K9 jchanges and performance is proposed for restructure of the United States health system.+ R) s" ?) Z! l& Y
Under the guidance of WHO Health System Performance Framework, we gain an insight of the
- q' U G$ o0 V g9 y: l! _6 ^9 xproblem. Focusing on the outcomes, health, responsiveness and financial protection, we devise
5 g+ P7 U' ?1 Cmetrics to build an index system for evaluat ion. Lists which describe each metric are presented c, T* W% M7 o U( x$ \
afterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried
7 K3 H, {; ]( {" R1 ^out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P) y. W3 z0 B$ l- A! C% D2 P
health care system. With these metrics, we can compare the relative quality of systems. After a
' j1 D0 k6 x0 |( Mthorough search of data sources, we refine the metrics list based on data availability, and also4 s. O& k0 z: E8 `$ T: v
present the estimating and obtaining approaches.0 f5 q- x# d9 W* j
For the purpose of international comparison, Principal Components Analysis is applied to choose
% R* ~ D& U, t/ ythe most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,
, s- R1 J1 M4 z: @+ e% j$ oimmunization coverage among 1-years-olds and fairness of financial contribution are finally
9 D. N( G! a0 \/ _ c! S4 G) q# Tselected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test v5 s- o" W6 f" K2 e
results between the United States and two other countries are showed below:
/ ?/ k' Y3 s9 a; M. X2 Z# nInvestigating the discrepancy between results, we attribute the cause to the differences in devise of
+ c9 ]+ q) f4 G4 ~$ ^, `9 i) p/ X9 j! N. umetrics and weights in CEM.5 o5 Q+ f8 d( E- E
Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is* n/ ]: }2 h \
introduced to find the relationship between the major contributing input factors and outcomes.
0 l1 ~5 a7 u9 x* ]4 ZFurther more, after analyzing the variations of functions, possible policy changes to improve are P, p( ]) B5 ~2 |0 q+ ~4 P
recommended, including strengthening primary care system and conducting a single payer system.
7 j" ^* U! x& x% U2 R: r0 @Finally, the strength and weakness of our models are summarized, as well as two urgent aspects for% V$ i, @. E1 k- A; V) e
future work. The main achievements and contributions of this ** are concluded in the end. |
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