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发表于 2010-1-22 13:57
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Summary0 w( |2 y, B/ A6 X# y. ^0 y
Social attention has been increasingly paid to health care systems varied in effectiveness and
6 f1 ^' P+ X& n% ]' _5 {5 I/ qefficiency. This ** addresses the assessment and prediction of health care system. First and
) a/ l. H# K8 n2 aforemost, a metrics list is established and refined for further assessment. Secondly, model tests are
/ _, o$ o3 w2 W# ]; Nconducted between countries. Thirdly, a predictive model based on the relationship between/ Y& w" ]+ E' o' L7 a
changes and performance is proposed for restructure of the United States health system.6 _# }- W0 }! l9 [
Under the guidance of WHO Health System Performance Framework, we gain an insight of the. h) P" O, H2 ^2 _
problem. Focusing on the outcomes, health, responsiveness and financial protection, we devise4 R& H3 i( g* H7 [" W
metrics to build an index system for evaluat ion. Lists which describe each metric are presented' q8 j6 Z8 [) C. v0 d$ Q
afterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried& P" ]6 V V6 ` d2 w- {* ?% g9 p
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P
+ G# F N3 X7 J/ U9 h1 a) {4 ^" ohealth care system. With these metrics, we can compare the relative quality of systems. After a; `: u0 A7 ~- _& O4 K( W# s
thorough search of data sources, we refine the metrics list based on data availability, and also
1 O' a6 a5 y+ h( E0 }present the estimating and obtaining approaches.
+ T I4 H( _" [0 l4 J0 x& WFor the purpose of international comparison, Principal Components Analysis is applied to choose+ ~) v; i: q" D- `$ j2 ~
the most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,: u0 n( a2 ^/ p" {
immunization coverage among 1-years-olds and fairness of financial contribution are finally
% j- C7 c! {7 o) B- r, Nselected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test
2 c% O/ w- n% v3 bresults between the United States and two other countries are showed below:
* @: q \8 h5 wInvestigating the discrepancy between results, we attribute the cause to the differences in devise of6 l+ R) b* ?' ]" k) z0 b
metrics and weights in CEM.
) Y1 R/ D9 @. A1 qThen we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is
/ u* f3 `, K' t; w: `) G7 H: B: \introduced to find the relationship between the major contributing input factors and outcomes./ ]% ~; y6 p9 j# H2 [. Q& ]( [2 {
Further more, after analyzing the variations of functions, possible policy changes to improve are
f* |/ ^2 o7 k9 \recommended, including strengthening primary care system and conducting a single payer system.. ? u8 k' B! p4 }; k; d+ u s
Finally, the strength and weakness of our models are summarized, as well as two urgent aspects for
9 d/ A/ N ?! f" }; o! e: Rfuture work. The main achievements and contributions of this ** are concluded in the end. |
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