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发表于 2010-1-22 13:57
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Summary) b* X# z" s# d8 K" n- e- W
Social attention has been increasingly paid to health care systems varied in effectiveness and
" P( T; q9 R/ ]- ~efficiency. This ** addresses the assessment and prediction of health care system. First and
8 w9 z+ G+ L; r2 }- v- Y1 {foremost, a metrics list is established and refined for further assessment. Secondly, model tests are
) \" k: r* s3 z: m4 v* |" a$ d2 oconducted between countries. Thirdly, a predictive model based on the relationship between7 u$ ?5 f% C* m3 A# o4 `
changes and performance is proposed for restructure of the United States health system. T! D5 |5 ]9 y5 ~0 B# U3 D/ a
Under the guidance of WHO Health System Performance Framework, we gain an insight of the
8 S9 o- F9 N* Hproblem. Focusing on the outcomes, health, responsiveness and financial protection, we devise; k0 ]1 w% J8 f7 Z% n( p& E
metrics to build an index system for evaluat ion. Lists which describe each metric are presented
/ e! m4 Q; l9 u; j1 }3 \% F0 yafterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried
! U6 Y4 T4 N. d- W2 e6 u+ O) b- vout, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P2 v5 r. D2 N/ f7 B
health care system. With these metrics, we can compare the relative quality of systems. After a5 T) x& B6 v6 i) f1 `
thorough search of data sources, we refine the metrics list based on data availability, and also2 _% @! ]$ k& ^ J5 v. ~, s. t
present the estimating and obtaining approaches.4 G4 H! h. P4 y: d
For the purpose of international comparison, Principal Components Analysis is applied to choose
$ `; C3 p. s7 f# g, y/ t2 O5 Kthe most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,- c% x4 o" {0 r, i8 Y
immunization coverage among 1-years-olds and fairness of financial contribution are finally% p0 c5 v; d- @$ ]% @5 ~2 M' L7 G/ I" @
selected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test
6 w6 a) t, |+ ~9 d- G' \9 zresults between the United States and two other countries are showed below:
6 ?" b0 C y1 O# uInvestigating the discrepancy between results, we attribute the cause to the differences in devise of
k1 K h% X1 Kmetrics and weights in CEM.# F; p; I0 f$ n. }2 T' {: y
Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is
V/ N, l* o# {+ [1 b3 aintroduced to find the relationship between the major contributing input factors and outcomes.7 q4 X5 G5 j( {4 l
Further more, after analyzing the variations of functions, possible policy changes to improve are0 L) h0 K: O3 Y% T P l- ?1 k. D
recommended, including strengthening primary care system and conducting a single payer system.9 S9 O3 G9 v& E
Finally, the strength and weakness of our models are summarized, as well as two urgent aspects for
& N' s# g( O" h8 p ]; ?& u% Jfuture work. The main achievements and contributions of this ** are concluded in the end. |
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