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发表于 2010-1-22 13:57
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Summary3 g) ^( F# i2 D: j% U$ d& [
Social attention has been increasingly paid to health care systems varied in effectiveness and
5 ], `! c% B5 M' Sefficiency. This ** addresses the assessment and prediction of health care system. First and# G0 C. K; y2 p
foremost, a metrics list is established and refined for further assessment. Secondly, model tests are
' t0 ?: q% B0 ]3 h3 @6 Zconducted between countries. Thirdly, a predictive model based on the relationship between
: a$ q3 d+ v5 u. {7 c! s7 q9 a$ Lchanges and performance is proposed for restructure of the United States health system.- x8 V2 k+ c% U+ |" M/ e! P- t8 \, k
Under the guidance of WHO Health System Performance Framework, we gain an insight of the
. k8 o' _! y, K* k5 a" r" Tproblem. Focusing on the outcomes, health, responsiveness and financial protection, we devise
6 t3 ~ U1 ^1 r4 I' s5 B3 bmetrics to build an index system for evaluat ion. Lists which describe each metric are presented# t. a/ k m- ]0 k4 K/ M
afterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried4 d% n' c- I; H* R( Y! {
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P* F9 z- d! ~) I$ N! k& G; |
health care system. With these metrics, we can compare the relative quality of systems. After a
2 |* X# o3 M) U9 W) r1 _thorough search of data sources, we refine the metrics list based on data availability, and also$ R6 e' i: S5 q4 W4 V
present the estimating and obtaining approaches.
# u4 Y- `# _ |4 j: u$ PFor the purpose of international comparison, Principal Components Analysis is applied to choose3 Q x- T2 d5 Y+ X
the most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,: @ M3 l8 B o" g; U9 U: r
immunization coverage among 1-years-olds and fairness of financial contribution are finally1 p4 m5 k& U# d$ s" m3 j
selected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test
h: Z0 A9 d2 g9 {results between the United States and two other countries are showed below:8 s$ w3 F% ^3 h+ f: F$ ~+ s
Investigating the discrepancy between results, we attribute the cause to the differences in devise of, _7 r/ ?8 c5 T$ J4 F
metrics and weights in CEM.% L9 Z! I! x( ~% d
Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is# ?( b" g5 Z6 k; h, \8 A
introduced to find the relationship between the major contributing input factors and outcomes.
& Q9 Y/ n( {! t3 v7 h* k# m- m* NFurther more, after analyzing the variations of functions, possible policy changes to improve are$ ?& J8 A1 W8 i: [4 B& z" Y: H
recommended, including strengthening primary care system and conducting a single payer system.
2 W* M" f: {9 sFinally, the strength and weakness of our models are summarized, as well as two urgent aspects for
1 p8 X+ k3 |' L$ n' {( K: vfuture work. The main achievements and contributions of this ** are concluded in the end. |
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