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发表于 2010-1-22 13:57
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Summary x* n% q2 z& `* q
Social attention has been increasingly paid to health care systems varied in effectiveness and
# ?7 h8 ?* M' Lefficiency. This ** addresses the assessment and prediction of health care system. First and, [9 C( A& ?6 I! t w
foremost, a metrics list is established and refined for further assessment. Secondly, model tests are
$ O3 x# l5 m O& d( }: k2 D8 i8 Tconducted between countries. Thirdly, a predictive model based on the relationship between
1 ~, f" y( ^, x7 `changes and performance is proposed for restructure of the United States health system.5 P/ _8 F3 S. u, l/ q& i7 I+ j
Under the guidance of WHO Health System Performance Framework, we gain an insight of the& h0 ^9 I+ R! \# r& w9 n; ]
problem. Focusing on the outcomes, health, responsiveness and financial protection, we devise' g& J! ^, ~4 E( ?% o; K
metrics to build an index system for evaluat ion. Lists which describe each metric are presented, G2 ^. v o) p/ g+ a0 B
afterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried
6 d+ M+ u1 s; j6 R+ M! N: Dout, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P
# t) z3 L1 Z( ?5 \. bhealth care system. With these metrics, we can compare the relative quality of systems. After a
& \ ]4 G; @4 @# g2 R; Q* z+ P' Gthorough search of data sources, we refine the metrics list based on data availability, and also
& N; s# K# ]$ @4 L) Bpresent the estimating and obtaining approaches.
0 v5 g r' Q% R1 l8 ]& `For the purpose of international comparison, Principal Components Analysis is applied to choose
8 ?! E1 B8 ?) R) N% B Pthe most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,
% P$ _* K, h& L$ ]immunization coverage among 1-years-olds and fairness of financial contribution are finally, h! F4 P/ f, U6 ]0 T& P, J
selected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test
( g* E& O- R- z7 l+ C. presults between the United States and two other countries are showed below:0 C, f) N6 p5 [6 D
Investigating the discrepancy between results, we attribute the cause to the differences in devise of; Q2 z; B" m4 ~* ` o# }0 Y
metrics and weights in CEM.
7 D+ V/ u9 |; @Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is# P/ { }7 I K- P+ L- D
introduced to find the relationship between the major contributing input factors and outcomes.
# {4 A3 e6 n; ], L& {% k, F6 ~ vFurther more, after analyzing the variations of functions, possible policy changes to improve are9 ?% ?5 D7 _# H
recommended, including strengthening primary care system and conducting a single payer system.
1 z3 m _- w: N# x5 N( gFinally, the strength and weakness of our models are summarized, as well as two urgent aspects for
8 ^: Y* o- f3 `- A6 bfuture work. The main achievements and contributions of this ** are concluded in the end. |
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