Healthcare Value Evaluation For Chronic Disease And Research On Resources Allocation

As the population ages and the pace of modern life quickens,number of patients with chronic diseases and demand for medical service resources are increasing year by year,which brings huge challenge to the healthcare service system of our country.It will have important guiding significance for solving problems such as low satisfaction and perceived value of patients,unreasonable allocation of medical resources if we quantify the value of healthcare service of chronic disease clearly.Based the three evaluation perspectives of healthcare value(chronic patients,healthcare institutions,government),this thesis focuses on the value formation and evaluation mechanism of chronic diseases healthcare from the perspectives of patient perception and social output,and the optimal allocation of government resources based on the healthcare value.In order to achieve the research goals,based on the patient perception value theory,value medical theory,health system strengthening theory and the characteristics of chronic disease diagnosis and treatment services,three empirical studies were conducted.Study Ⅰ aimed at the problem of patients’ low perceived value,analyzed the key factors and paths that affect the value perception of patients with chronic diseases.Based on the theory of technology acceptance model and patient perception value,this paper explores how the patient’s emotional attitudes such as perceived usefulness,patient satisfaction,technical fear,subjective norms ultimately affect the patient’s perceived value.A two-stage survey was conducted to analyze the impact path of patient perception value in mobile-health mode and in hospital diagnosis mode.The results of SEM analysis showed that:(1)Patient satisfaction,subjective norms and perceived usefulness always had the greatest impact on patients’ perceived value.(2)Patients in mobile-health pay more attention to service satisfaction,but patients in hospital concern more about subjective norms.(3)Technology fear and perceived ease of use have a significant impact on patient perceived value only in mobile-health mode,so mobile-health design needs to be more human and intelligent.Study Ⅱ aimed at the problem of low utilization rate of healthcare resources,and the study defines a hospital value measurement formula of the effect-cost ratio from the perspectives of society,which is measured from four dimensions and 17 indicators including health benefit,social benefit and economic benefit.In addition,the paper quantifies interaction relation between value indexes by the method of DEMATEL and differentiation degree of medical service by the method of information entropy,which are reflected to the index weight to increase the index weight of cause node and high homogeneity of medical institution.The evaluation results shows that the healthcare value of community hospitals is 14.3% higher than higher hospital and 25.4% higher than mobile medical platform,which indicates that community hospital has the highest resource use efficiency in health caring chronic disease.Study Ⅲ aimed at maximize the social value generated by government input,and the allocation of medical resources and social value generated is quantitatively described through establishing a mixed-integer nonlinear programming model.Considering the contribution of enhancing medical systems to social health and the fairness of resource allocation by definition constraint,the model identifies funding for chronic disease intervention program and numbers of health system strengthen funding in case study by applying the improved adaptive genetic algorithm programming solution model.In brief,this thesis,taking the value of healthcare service of chronic disease as research center,establishes a patient-oriented model of patient perceived value-impact-relationship.Then,it quantitatively evaluates the value of healthcare service of chronic disease from the perspective of society based on the effect-cost ratio.As a conclusion,the paper proposes a valuebased resource allocation method paralleling medical system strengthening and disease intervention,and maximizes social value of healthcare service of chronic disease in the circumstance of limited resources,which provides references and suggestions for the implementation of hierarchical healthcare of chronic disease and the allocation of prevention and treatment resources.