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发表于 2010-1-22 13:57
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Summary
3 I% y8 U+ n! P7 J" `Social attention has been increasingly paid to health care systems varied in effectiveness and
1 t; Y9 `( B( S; K6 q) Uefficiency. This ** addresses the assessment and prediction of health care system. First and
. ^/ G. O1 T( a# R V' H* wforemost, a metrics list is established and refined for further assessment. Secondly, model tests are& r4 D/ T+ u% _# W0 y+ Y1 ?
conducted between countries. Thirdly, a predictive model based on the relationship between
: g" `# u, `+ f# W3 Y" x* }changes and performance is proposed for restructure of the United States health system.
1 R4 z: S& X9 c5 O k3 y. EUnder the guidance of WHO Health System Performance Framework, we gain an insight of the
: C8 h+ G8 W. qproblem. Focusing on the outcomes, health, responsiveness and financial protection, we devise
: x/ Z+ C: ?5 O' C; Z5 L+ E5 Z. Mmetrics to build an index system for evaluat ion. Lists which describe each metric are presented& r7 f7 u0 Q4 W' A+ ^8 B- e
afterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried: V w6 m$ o3 @* X! p" o
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P% [: D, Y; M$ P% F- N9 P- A
health care system. With these metrics, we can compare the relative quality of systems. After a8 |* v! R+ v, R
thorough search of data sources, we refine the metrics list based on data availability, and also4 ^* o8 @7 l- o- z
present the estimating and obtaining approaches.4 ]5 i3 u5 F1 ?$ ]
For the purpose of international comparison, Principal Components Analysis is applied to choose
; A% p; Y4 X" y0 E" D4 mthe most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,, q3 W# M- s1 I' ^
immunization coverage among 1-years-olds and fairness of financial contribution are finally
8 K3 A* w/ h4 T2 r2 i/ Xselected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test/ k3 U( ?$ m1 w# U: R/ v
results between the United States and two other countries are showed below:
6 V: G2 ?% I6 f. yInvestigating the discrepancy between results, we attribute the cause to the differences in devise of
) d: @- I& i3 i6 \metrics and weights in CEM.* L% E# a6 h; M* N
Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is$ ?9 g$ W2 q: a9 w
introduced to find the relationship between the major contributing input factors and outcomes.7 E: I0 j+ E% o, L) p( B
Further more, after analyzing the variations of functions, possible policy changes to improve are
- O4 j) C2 H2 p6 S5 ?4 S, e' g1 Krecommended, including strengthening primary care system and conducting a single payer system.
* y b6 G9 G! zFinally, the strength and weakness of our models are summarized, as well as two urgent aspects for. k7 o8 t- W* n6 \
future work. The main achievements and contributions of this ** are concluded in the end. |
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