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发表于 2010-1-22 13:57
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Summary; }+ d9 U% K1 p3 l
Social attention has been increasingly paid to health care systems varied in effectiveness and
" h, x4 l t4 d* h3 b8 Hefficiency. This ** addresses the assessment and prediction of health care system. First and/ h$ [; ?- j6 ~% n& e$ f, @: U
foremost, a metrics list is established and refined for further assessment. Secondly, model tests are* x2 Q/ o4 ?9 D& Z" r
conducted between countries. Thirdly, a predictive model based on the relationship between
2 C8 }& W; |( ~$ ~% Ichanges and performance is proposed for restructure of the United States health system.
R# K i* o I1 LUnder the guidance of WHO Health System Performance Framework, we gain an insight of the9 o% X# n* U! z T8 a, o
problem. Focusing on the outcomes, health, responsiveness and financial protection, we devise J: y6 V. e* r3 G5 r6 g) {
metrics to build an index system for evaluat ion. Lists which describe each metric are presented
+ t8 ^4 u4 e9 w) j, Jafterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried+ u% l3 P- j8 Q5 E
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P
9 b$ d, ?3 ?0 t' ]4 P5 C @+ P8 N; t2 I& ehealth care system. With these metrics, we can compare the relative quality of systems. After a" o7 ~1 Q6 E0 T+ t3 @
thorough search of data sources, we refine the metrics list based on data availability, and also) y; G; z$ u/ j) T; t4 m: Q9 z
present the estimating and obtaining approaches.
o) ?& P$ x4 T, t# G! ^$ OFor the purpose of international comparison, Principal Components Analysis is applied to choose+ c( E) }; Z1 _" c) Y. M' U9 ]
the most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,
( N! {" t3 M- w9 ]; S0 A" wimmunization coverage among 1-years-olds and fairness of financial contribution are finally y- z' h) U" G$ L3 k0 b
selected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test' j% A" n/ }5 d# m/ E W
results between the United States and two other countries are showed below:
* G: z7 Z4 C2 B5 X2 UInvestigating the discrepancy between results, we attribute the cause to the differences in devise of/ }" {+ j- \1 g) |6 o
metrics and weights in CEM.0 ]4 D% z( h0 q3 f, |/ s
Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is
: x# k$ e% y( ], I0 d" _7 C$ Gintroduced to find the relationship between the major contributing input factors and outcomes.1 D0 E. d! z/ z! T
Further more, after analyzing the variations of functions, possible policy changes to improve are1 w( P5 W/ w2 { I
recommended, including strengthening primary care system and conducting a single payer system.
" [8 c3 `9 E0 F7 `6 XFinally, the strength and weakness of our models are summarized, as well as two urgent aspects for
D' R8 \0 t) ?+ B, I4 z0 f+ ^future work. The main achievements and contributions of this ** are concluded in the end. |
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