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发表于 2010-1-22 13:57
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Summary
3 u4 S' x2 n" lSocial attention has been increasingly paid to health care systems varied in effectiveness and
/ M8 Z7 T5 n' s. S+ e E7 p* h. pefficiency. This ** addresses the assessment and prediction of health care system. First and
' c( y4 b7 n) \/ @5 L2 e4 Qforemost, a metrics list is established and refined for further assessment. Secondly, model tests are
. R; S9 O# [8 G: e) ?conducted between countries. Thirdly, a predictive model based on the relationship between
& k& m7 ^- g O2 [" Z* Wchanges and performance is proposed for restructure of the United States health system.
5 k/ Q6 @) j* {% l2 x, `Under the guidance of WHO Health System Performance Framework, we gain an insight of the- x7 Q8 P1 i1 m- X" q5 K' y% P& c$ ~
problem. Focusing on the outcomes, health, responsiveness and financial protection, we devise
! Q( r+ g7 o. t$ t! d, imetrics to build an index system for evaluat ion. Lists which describe each metric are presented
2 I' d* F- Q0 ~$ U3 p1 v' mafterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried2 |0 }2 s) \7 o9 N
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P
0 x# v4 b. P _3 x' o5 G" Thealth care system. With these metrics, we can compare the relative quality of systems. After a
0 _3 F% u4 X1 dthorough search of data sources, we refine the metrics list based on data availability, and also
/ M9 J! N# F1 y& C! H, B+ I9 [present the estimating and obtaining approaches.! W/ X+ B1 n X+ |
For the purpose of international comparison, Principal Components Analysis is applied to choose o/ |& g+ ?5 M* n$ S
the most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,
" w2 ?+ V8 s" O6 Y, l, iimmunization coverage among 1-years-olds and fairness of financial contribution are finally
( g% n& M2 k Z" z& F8 Wselected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test/ J) M1 S. W' R) v7 z1 H H
results between the United States and two other countries are showed below:! m8 E1 t2 L, F8 s
Investigating the discrepancy between results, we attribute the cause to the differences in devise of8 }5 ]) ~5 {* E4 h
metrics and weights in CEM.6 v) @1 a7 s! b; o
Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is0 ], ]' \/ a2 o2 |9 Y
introduced to find the relationship between the major contributing input factors and outcomes.
0 O. a5 M" y$ \* u$ J$ KFurther more, after analyzing the variations of functions, possible policy changes to improve are0 m: w/ ~$ K1 k
recommended, including strengthening primary care system and conducting a single payer system.
" U; W( Z8 {0 B/ W4 f* RFinally, the strength and weakness of our models are summarized, as well as two urgent aspects for
4 p) w2 S' ?8 G6 E0 Q) M2 E: jfuture work. The main achievements and contributions of this ** are concluded in the end. |
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