卫生保健系统外文翻译.docx

卫生保健系统外文翻译.docx

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卫生保健系统外文翻译

毕业设计（论文）外文参考资料

（原文与译文）

外文题目：

Healthcaresystem

中文题目：

卫生保健系统

作者：

RalphKimball

专业：

软件工程

班级：

软件班

学号：

姓名：

2011年6月10日

Healthcaresystem

Nowadays,thehealthcaresystemswhichareprovidedbynationshaveimprovedtheirresidents’healthremarkably.TaketheUSAforexample,thelifeexpectancyatbirthhasraisedto80yearsold,whiletheinfantmortalityhasdeclinedto7‰.Inothercountriesoftheworld,thesimilarsituationalsoexistswidely.

Sincethehealthcaresystemsareplayingmoreandmoreimportantrolesinnationalhealth,peopleoftenpaymuchattentiontowhichsystemsarebetterandwhetherthecurrentsystemscanbeimproved.However,theaspectsofthesesystemsthatvarywidelybetweennations（suchashowtheyarefunded,themodewhichservicesaredelivered,percentageofGDPspentonhealthcare,thepersonallivinghabitsandsoon）aresomanythatitishardforustodeterminewhichsystemisbetter.Actually,itisimpossibleandnotnecessaryforustousethedataaboutalltheaspects,thusourtasksaretochooseandcombinesomemetricstoevaluateahealthcaresystemwithsufficientreasons.ThentheevaluationmethodisusedbetweentheUSAandanothercountrytocheckupwhetheritisavailable.

Usingtheevaluationmethod,wecangainthattheeffectivenessbetweendifferenthealthcaresystemsisdifferent,whichmeansthereisstillalongwayfornationstoimprovetheirhealthcaresystems.Basedonthefactthatanymeasuresthatanationtakescanaffecttheeffectivenessofthehealthcaresystemsevidently,ifwewanttogetmuchbettereffectivehealthcaresystems,someusefulmeasuresareabsolutelynecessary.

PartI:

Choosingandcombiningmetrics

1.1Choosingmetrics

Asweallknow,aspectsofhealthcaresystemsvarywidelybetweennations,allofwhichcanreflecttheeffectivenessofhealthcaresystemstoacertainextent.However,accordingtotheWorldHealthStatisticsgivenbytheWHO,thenumberofmetricsismorethan70,itisnearlyimpossibleforustoevaluateahealthcaresystemusingallofthemetrics.

Tosimplifytheevaluation,wehavechosensomeimportantmetrics,whichcanaffecttheeffectivenessofhealthcaresystemsmoreremarkably.Generally,ahealthcaresystemcanbeevaluatedfromthefollowingsixaspects:

1）Mortality

2）Morbidity

3）Coverage

4）Healthsystemsresource

5）Healthsystemsexpenditure

6）Inequity

Inallusiontoeachaspect,therearesomerepresentativemetrics.

1.1.1Thereasonforthechoiceofmortality

RefertotheworldhealthstatisticsgivenbytheWHO,mortalityshouldincludelifeexpectancy,healthylifeexpectancy,infantmortalityrate,neonatalmortalityrate,maternalmortalityratio,cause-specificmortalityrateandsoon.

Outofquestion,thelifeexpectancyshouldbethemostimportantmetrics,forallthehealthcaresystemsaimtoextenditaslongaspossible.Besides,generallyspeaking,infantsandpregnantwomenoftenhavetheweakestvitality,thusinfantmortalityrate;neonatalmortalityrateandmaternalmortalityratecanbechosentoinfecttheeffectivenessofacertainsystem.However,anotherimportantfunctionofahealthcaresystemisthecureforsometypicalepidemicdiseases,hencethemortalityrateoftypicalepidemicsufferershouldalsobeinourconsideration.

Inconclusion,thechosenmetricsofmortalityare:

1）Lifeexpectancy

2）Infantmortalityrate

3）Neonatalmortalityrate

4）Maternalmortalityrate

5）Mortalityrateoftypicalepidemicsufferer

1.1.2Thereasonforthechoiceofmorbidity

Forahealthcaresystem,itsfunctionisnotonlythecurefordiseasesbutalsopreventingthem.Concretely,theeffectivenessofpreventioncanberepresentedbymorbidityoftypicalepidemicdiseases.

1.1.3Thereasonforthechoiceofcoverage

Itisatruththateachpersonshouldhastheequalrighttoenjoythehealthcaresystem,whichistheaimpursuedbyacountryatthesametime.Butinfact,it’sreallyalongwaytogotogainthisendsforthereareallkindsofimpeditivefactors.Consequently,weneedtodeterminethecoverageofsomemedicaltreatmentssuchas:

1）Immunizationcoverage

2）Antenatalcarecoverage

3）Contraceptiveprevalencerate

4）Proportionofthepopulationwithouthospitalizationinsurance.

1.1.4Thereasonforthechoiceofhealthsystemsresource

Inouropinions,themoreresourceahealthcaresystemhas,thebettereffectivenessitwillbe,whichmeansthehealthcaresystems’resourceisanotherimportantevaluateaspect.However,sincepopulationsofeachcountrywidelyvarybetweennations,thepercapitashareofresourcesmayrepresentthehealthsystemresourcemorereasonably.Thecorrespondingmetricsare:

1）Humanresourceofhealthsystemsas%oftotalpopulation

2）Percapitamaterialresourcesofhealthsystems

1.1.5Thereasonforthechoiceofhealthsystemsexpenditure

Peopletypicallycomeintodirectcontactwithahealthsystemaspatients,attendedbyproviders,onlyonceortwiceayear.Moreoftentheircontactisasconsumersofnonprescriptionmedicationsandasrecipientsofhealth-relatedinformationandadvice.Theymeetthesystemascontributorstopayingforit,knowinglyeverytimetheybuycareoutofpocketorpayinsurancepremiumsorsocialsecuritycontributions,andknowinglywhenevertheypaytaxesthatareusedinpartoffinancehealth.

Basedonthefactthatthehealthcaresystemsexpenditureismadeupoftwoparts,whereonepartisexpendedbyindividualsandtheotherisexpendedbygovernments.However,bothofthemcanberepresentedastotalexpenditureonhealthofGDP,thuswechoosethreemetricsinthispart:

1）Thetotalexpenditureonhealthas%ofGDP

2）Governmentandprivateexpenditureonhealthas%ofTotalexpenditureonhealth

3）Percapitatotalexpenditureonhealth.

1.1.6Thereasonforthechoiceofinequities

Theresourcesdevotedtohealthsystemsareveryunequallydistributed,andnotatallinproportiontothedistributionofhealthproblems.Foranidealhealthcaresystem,everypersonshouldreceivemostthesamemedicaltreatment,howeverthingsgocontrarytoourwishes,thereareinequitablefactorsnecessarilywhentheresourceofhealthcaresystemsaredistributed,generallyspeaking,theinequitiesmustexistbetweenpersonsandregions.Sotheinequitiesshouldnotbeignored.

1.1.7Aggregatethechosenmetricsinatable

Tomakethechosenresultsmoreclearly,weconcludedtheminthefollowingtable.（refertotable1）

Table1.MetricsIdentified

Aspect

FoundationalMetrics

mortality

Lifeexpectancy

Infantmortalityrate

Neonatalmortalityrate

Maternalmortalityratio

mortalityrateoftypicalepidemicsufferer

morbidity

typicalepidemicmorbidity

coverage

Immunizationcoverage

Antenatalcarecoverage

Contraceptiveprevalencerate

Proportionofthepopulationwithouthospitalizationinsurance

Healthsystemsresource

humanresourceofHealthsystemsas%oftotalpopulation

PercapitamaterialresourcesofHealthsystems

Healthsystemsexpenditure

Totalexpenditureonhealthas%ofGDP

GovernmentandPrivateexpenditureonhealthas%ofTotalexpenditureonhealth

Percapitatotalexpenditureonhealth

Inequities

Inequitiesinhealth

1.2Metricsusedtocomparebetweenexistingandpotentialsystems

Cost-effectivenessanalysis,now,isessentialforidentifyingtheservicesthatwillproducethemosthealthgainfromavailableresources,butithastobeappliedtoindividualinterventions,notbroadlyagainstdiseaseorcauses.However,ontheonehand,thecostscanvarygreatlyfromonecountryandinterventionmodetoanother;ontheotherhand,itwillbechangedalongwiththedevelopmentofeconomyinapotentialsystem.What’smore,generallyspeaking,themorethecostis,thebettereffectivenessis,whichmeansthechangeofeffectivenessdependentsonthecost’schangetoagreatextent.

Thusthefirststeptomakecomparisonsbetweenexistingandpotentialsystemsistodividethemetricsintocostandeffectiveness,andthenusethecosttodeterminewhichsystemisbetter.

1.2.1Classingthechosenmetrics

Thecostsheremainlyrefertothemeasureswhichcanbechangebypeople,suchashowmuchcanbeaccomplishedwithcurrentlyavailableresources–people,buildings,equipmentandknowledge–dependsgreatlyonthepastinvestmentandtraininthatcreatedthoseresources.

Correspondingwiththemetricswehavechosen,thecostsarehealthsystemsresource,healthsystemsexpenditureandinequities.Sincethemcanbechangebypeopleandcanaffecttheeffectivenessofasystemsdirectly,weusethemtocomparethecurrentandpotentialsystems.

Byallappearances,therestmetricswehavechosenshouldbetheeffectiveness.

1.2.2Concludethemetricsusedtocompare

Basedontheanalysisabove,themetricsusedtomakecomparisonsbetweenexistingandpotentialsystemsareshowninthetable2

Table2.MetricsUsedtoMakeComparisons

Healthsystemsresource

humanresourceofHealthsystemsas%oftotalpopulation

PercapitamaterialresourcesofHealthsystems

Healthsystemsexpenditure

Totalexpenditureonhealthas%ofGDP

GovernmentandPrivateexpenditureonhealthas%ofTotalexpenditureonhealth

Percapitatotalexpenditureonhealth

Inequities

Inequitiesinhealth

1.3Combiningthechosenmetrics

Refertotheaboveanalysisthatthecost-effectivenessanalysisisessentialforidentifyingthesystemsthatwillproducethemosthealthgainfromavailableresources,hencethesortwehaveclassedcanalsobeusedinthisproblem.

Forthemetricsincludedinthecost,wecancombinethemtogetacompositivecostindex,similarly,anothercompositiveeffectivenessindexcanbeobtained