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