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发表于 2010-1-22 13:57
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Summary
9 |7 O) f. a/ T7 lSocial attention has been increasingly paid to health care systems varied in effectiveness and5 a) g" y5 n* p7 m% }
efficiency. This ** addresses the assessment and prediction of health care system. First and- F+ A' E. ?$ k' ~! \/ Z) m2 b
foremost, a metrics list is established and refined for further assessment. Secondly, model tests are; E5 Q8 v- y( U) @9 ]- F
conducted between countries. Thirdly, a predictive model based on the relationship between; i9 u7 `( Q: R/ Z% v; } x
changes and performance is proposed for restructure of the United States health system.
; y' ^* k5 f: J3 A0 ?. gUnder the guidance of WHO Health System Performance Framework, we gain an insight of the3 i' R; E8 u! u3 V& b
problem. Focusing on the outcomes, health, responsiveness and financial protection, we devise
- y [$ k# ^/ L/ P# tmetrics to build an index system for evaluat ion. Lists which describe each metric are presented
+ Q" h N: V) \; R' x2 G; vafterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried. v8 {3 U6 V) w" S3 |' _& W! j2 B6 s7 h
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P5 o$ f Y9 b! F. e' z
health care system. With these metrics, we can compare the relative quality of systems. After a3 a/ g; y- l- V( v4 |
thorough search of data sources, we refine the metrics list based on data availability, and also/ _/ q6 F5 f" l2 Z* f
present the estimating and obtaining approaches.
, T5 V& _# X! O7 F+ m2 CFor the purpose of international comparison, Principal Components Analysis is applied to choose
, }, z8 E f( o4 gthe most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,
* g% j) A" r: B- Z$ S* D% |immunization coverage among 1-years-olds and fairness of financial contribution are finally
6 l, L* g X& a5 Z, p) ^) Wselected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test. _5 J5 ]0 L; P* R
results between the United States and two other countries are showed below:2 K: D/ Y$ X7 H' V. r' _' e r
Investigating the discrepancy between results, we attribute the cause to the differences in devise of
; q: w6 T4 @0 ?4 S* {7 hmetrics and weights in CEM.- d9 Q2 [" O; O# ~. ]. B
Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is
9 ]* r1 a. M, R9 P$ eintroduced to find the relationship between the major contributing input factors and outcomes.' W9 Z9 O4 {( }% Z
Further more, after analyzing the variations of functions, possible policy changes to improve are
5 v- y' m# L1 D* y) y) A( x5 |recommended, including strengthening primary care system and conducting a single payer system.
0 M& s9 V! t7 A% zFinally, the strength and weakness of our models are summarized, as well as two urgent aspects for
" F& O% ?4 M w: f3 E- Z- ufuture work. The main achievements and contributions of this ** are concluded in the end. |
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