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发表于 2010-1-22 13:57
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Summary
5 G7 `+ Q& T4 U5 K3 RSocial attention has been increasingly paid to health care systems varied in effectiveness and# S5 }" @! O- e% J6 f5 f9 X
efficiency. This ** addresses the assessment and prediction of health care system. First and
6 Y, }0 A: W: Pforemost, a metrics list is established and refined for further assessment. Secondly, model tests are# d; c4 B7 c1 i+ M F
conducted between countries. Thirdly, a predictive model based on the relationship between
5 P7 v. M: W) }/ N2 A5 ]8 ?4 Cchanges and performance is proposed for restructure of the United States health system.* z4 h5 q2 y) H. F+ A/ c
Under the guidance of WHO Health System Performance Framework, we gain an insight of the6 k- X v. w) G. C; c
problem. Focusing on the outcomes, health, responsiveness and financial protection, we devise+ e* J- r# [" g
metrics to build an index system for evaluat ion. Lists which describe each metric are presented
: s$ M. b/ N0 K3 K1 K: R q. ?afterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried. W- e6 |& C! X4 a6 z
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P
- K: o- L* \$ Y' ~) j1 u- |6 Phealth care system. With these metrics, we can compare the relative quality of systems. After a
+ S+ t8 B" X5 \! ]2 g9 s: e& t% y8 B3 Y+ athorough search of data sources, we refine the metrics list based on data availability, and also
) |& }! c. S3 ?7 T3 a+ {' T* ?! xpresent the estimating and obtaining approaches.: |$ e% g1 k+ M7 N6 i7 J. r s+ E
For the purpose of international comparison, Principal Components Analysis is applied to choose
a1 k" K8 R. U& ^8 gthe most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,2 {9 e( X1 B8 F3 @6 j& R1 x2 j
immunization coverage among 1-years-olds and fairness of financial contribution are finally$ K/ H- [5 ~: Z' B* f
selected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test
a# V( ~ F0 G5 aresults between the United States and two other countries are showed below:
! F8 ?/ d$ R& g5 W' ?: F& cInvestigating the discrepancy between results, we attribute the cause to the differences in devise of+ ]/ p1 x1 `( f5 V
metrics and weights in CEM.
$ J' p# x; A( F! \$ r( E. WThen we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is9 P ^! g4 s% H) E$ W; C6 A
introduced to find the relationship between the major contributing input factors and outcomes.; i9 w3 [. Q# j3 y3 M
Further more, after analyzing the variations of functions, possible policy changes to improve are
- r! X. n: b8 g! f6 _recommended, including strengthening primary care system and conducting a single payer system./ a. z5 y, c# B5 ]
Finally, the strength and weakness of our models are summarized, as well as two urgent aspects for3 F3 e+ G d B0 \' T" b( Y7 |: u+ {
future work. The main achievements and contributions of this ** are concluded in the end. |
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