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发表于 2010-1-22 13:57
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Summary0 T0 z% b9 \8 A3 D# A
Social attention has been increasingly paid to health care systems varied in effectiveness and4 ]5 T7 T# ? c
efficiency. This ** addresses the assessment and prediction of health care system. First and! F% Z0 [- a$ a9 T8 x. D/ f. ~& i
foremost, a metrics list is established and refined for further assessment. Secondly, model tests are' B1 {3 f% L+ y' N7 u E
conducted between countries. Thirdly, a predictive model based on the relationship between5 o; Z+ [ B( O' d- ^3 p. N
changes and performance is proposed for restructure of the United States health system.
$ w `$ ^ k( Y( d) q \' [3 MUnder the guidance of WHO Health System Performance Framework, we gain an insight of the
- C) ?; v' y2 xproblem. Focusing on the outcomes, health, responsiveness and financial protection, we devise
0 e6 C7 z1 @7 V- e1 w9 Cmetrics to build an index system for evaluat ion. Lists which describe each metric are presented
$ }5 f9 [5 _ a. I8 C2 R0 k" Z# \afterwards. Using Comprehensive Evaluation Method (CEM), combinations of metrics are carried0 K& S+ {2 [- s% i6 k* {$ N8 y
out, yielding metric o for effectiveness and for efficiency , which are the ultimate goals of A o P$ `8 a \( H3 D" s M5 {% ~% i
health care system. With these metrics, we can compare the relative quality of systems. After a
2 N; W6 R* E( B- k: W, ^' O/ lthorough search of data sources, we refine the metrics list based on data availability, and also8 ~4 L9 n) ^9 v8 ?5 ]- i# C i1 J5 U& z
present the estimating and obtaining approaches.2 x) H2 O5 q: D4 u
For the purpose of international comparison, Principal Components Analysis is applied to choose: t$ G3 [- p9 x2 Y( X2 u2 \
the most important and viable metrics. Life expectancy at birth, prevalence of tuberculosis,( U& i3 F/ u J$ d7 [
immunization coverage among 1-years-olds and fairness of financial contribution are finally
/ C0 M2 J% v. D& b8 fselected. Then modified Analytical Hierarchy Process is processed to weigh each metric. The test
) |# N6 b( [0 |results between the United States and two other countries are showed below:
$ \. a$ X( D8 m0 o* T0 VInvestigating the discrepancy between results, we attribute the cause to the differences in devise of
$ X; s( _5 d+ ^* k! w1 umetrics and weights in CEM.* J( s1 @! Y* o
Then we propose a novel framework for prediction of restructure. Stepwise Regression Analysis is
/ @4 J( m8 s7 h' E; Fintroduced to find the relationship between the major contributing input factors and outcomes." T' \. G2 S3 e/ V
Further more, after analyzing the variations of functions, possible policy changes to improve are" U/ ]2 S! c' a3 e
recommended, including strengthening primary care system and conducting a single payer system.& i% l* R+ \: S( ^5 d. L
Finally, the strength and weakness of our models are summarized, as well as two urgent aspects for
" D4 U. q) i$ qfuture work. The main achievements and contributions of this ** are concluded in the end. |
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