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发表于 2010-1-22 13:57
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Summary
) A6 J+ b. a1 b8 @. ZSocial attention has been increasingly paid to health care systems varied in effectiveness and
r6 L# e, I& R, S' M6 D! defficiency. This ** addresses the assessment and prediction of health care system. First and
! x4 X4 s; D2 b# N+ A/ x4 ]9 B' f% cforemost, a metrics list is established and refined for further assessment. Secondly, model tests are
0 K( e5 k3 F. B& |0 C3 r+ zconducted between countries. Thirdly, a predictive model based on the relationship between& h7 P* L9 ]$ m# t: d: a
changes and performance is proposed for restructure of the United States health system." `0 U' M$ F7 L
Under the guidance of WHO Health System Performance Framework, we gain an insight of the
* G5 T; ?+ C7 G( Q1 M( ^: J- ^problem. Focusing on the outcomes, health, responsiveness and financial protection, we devise
8 L( O+ d' O) w, Z8 Smetrics to build an index system for evaluat ion. Lists which describe each metric are presented! n) D: k0 _' P7 B q
afterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried4 l1 r7 w' T/ X4 F. [% I
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P- s% m' P! S5 ?! }
health care system. With these metrics, we can compare the relative quality of systems. After a# @4 }. Y) s/ N- \8 r0 p6 h# }
thorough search of data sources, we refine the metrics list based on data availability, and also6 i# V+ B2 ]* p
present the estimating and obtaining approaches.: E0 s k5 ~1 V
For the purpose of international comparison, Principal Components Analysis is applied to choose
3 S8 v# n7 K$ w: E) L- T9 {' p2 Cthe most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,' L1 h; L. v6 Q! F6 [
immunization coverage among 1-years-olds and fairness of financial contribution are finally, q: c; u X4 A0 r" L( \
selected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test
" g2 S+ n3 T0 v4 z& ~" Vresults between the United States and two other countries are showed below:' s$ F' N9 \) v6 x" x: K, z
Investigating the discrepancy between results, we attribute the cause to the differences in devise of/ O- r5 o$ \% ]
metrics and weights in CEM.
1 ^0 ~+ S& T9 z1 HThen we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is; ~' l$ p; @9 z' H* J4 j
introduced to find the relationship between the major contributing input factors and outcomes.
: K) J# T7 H+ {( I9 {, K4 eFurther more, after analyzing the variations of functions, possible policy changes to improve are
9 N4 m$ Z8 j8 @- U0 Z7 |recommended, including strengthening primary care system and conducting a single payer system. c& |( L/ }0 t; m
Finally, the strength and weakness of our models are summarized, as well as two urgent aspects for% g; F" ^( B C
future work. The main achievements and contributions of this ** are concluded in the end. |
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