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发表于 2010-1-22 13:57
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Summary
/ ]5 l9 v% j* A* k Y, B( kSocial attention has been increasingly paid to health care systems varied in effectiveness and
/ \5 j6 k* d/ f; X1 [& K) L7 |% N5 fefficiency. This ** addresses the assessment and prediction of health care system. First and1 J5 ~, Z1 K O a) G v# T. f
foremost, a metrics list is established and refined for further assessment. Secondly, model tests are7 [8 Y, X0 w+ y- i E: y- w
conducted between countries. Thirdly, a predictive model based on the relationship between
# x6 A% w# X+ w3 l' jchanges and performance is proposed for restructure of the United States health system.
& K/ C. e0 M0 V. SUnder the guidance of WHO Health System Performance Framework, we gain an insight of the
& }- ^, s: Q1 k. e3 J& e. Iproblem. Focusing on the outcomes, health, responsiveness and financial protection, we devise
* c0 [, j' [) V) K+ Ametrics to build an index system for evaluat ion. Lists which describe each metric are presented
& u% e( q. j* s+ s1 G' u" c" kafterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried$ U( C/ I0 Q' Q/ Q9 Z
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P' z) I! T j c& K8 x0 U
health care system. With these metrics, we can compare the relative quality of systems. After a
/ n) d4 ^! ^* U* G5 `" V2 O. rthorough search of data sources, we refine the metrics list based on data availability, and also
& a/ ^0 X* u! ~' O6 f, O. Apresent the estimating and obtaining approaches.
. n& [. f3 g5 q3 U0 C' N7 Q5 YFor the purpose of international comparison, Principal Components Analysis is applied to choose
* P9 s0 D0 P- D0 u9 d6 p9 [7 nthe most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,
1 z2 _' U' o4 y2 q! r# r" A% \$ V- Mimmunization coverage among 1-years-olds and fairness of financial contribution are finally- T# b1 r6 v0 l/ n t
selected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test" z2 K. H/ G3 q- D7 A- ^2 G @
results between the United States and two other countries are showed below:. g7 |9 f J* j' Y! n g$ q; B0 z
Investigating the discrepancy between results, we attribute the cause to the differences in devise of& S& q( M" Z4 a5 E0 x- H+ ~, A
metrics and weights in CEM.) ^# h3 V1 ^0 O R9 n
Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is
2 R$ t, p Z- {introduced to find the relationship between the major contributing input factors and outcomes.
" m2 ]. J! l7 t" c" Q1 PFurther more, after analyzing the variations of functions, possible policy changes to improve are
' }- | C/ ^4 b9 ]% Z8 G) i1 Frecommended, including strengthening primary care system and conducting a single payer system.2 d- O# g8 u3 ]
Finally, the strength and weakness of our models are summarized, as well as two urgent aspects for
' I/ x% ~& J* afuture work. The main achievements and contributions of this ** are concluded in the end. |
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