Analysis On The Performance Assessment Of Regional Vertical Medical Association With Close Cooperation Using The Artificial Neural Networks

BackgroundUnder the background of medical reform,it is required to improve the utilization efficiency of health resources.Since reform and opening-up policy,China's medical and health system reform has made some achievements,but in reality there are inequity,waste and loss of the medical resources in allocation and investment problems such as inefficient.The new medical reform uses the experience of the former reforms for reference and puts forward: strengthen regional health planning,make full use of and optimize the configuration of existing health resources,improve the efficiency of medical and health system,service level and quality,and gradually integrate medical institutions which do not meet the requirements of the planning,encourage the co-construction and sharing of resources between different medical institutions,improve the utilization efficiency of health resources.In the context of health integration,public medical institutions should be promoted to change the service mode.Resource integration,cooperative development is an international trend,and the concept and trend of this integration has been developed into the health field,which is manifested as an international trend,namely,integrated health care.With the deepening of reform and opening-up policy,the living environment,competitors and competition situation of medical institutions at all levels,especially hospitals,are undergoing great changes.At the same time,the existence of China's medical and health service system in the allocation of health resources is not reasonable.And the public medical institutions at all levels and of regional segmentation and cross-functional problems of public medical institutions at all levels and the traditional service mode makes the corresponding adjustment,in order to better integrate and utilize the limited medical resources.The practice of health service requires in-depth study of the assessment mode and method of medical association.Through the way of constructing medical association,the health service system of our country can be reconstructed.And problems such as,the current public hospital market fragmentation,the unreasonable resources disposition,the residents' disorderly seeing a doctor and so on can be alleviated.So as a kind of new cooperation and competition mode and an important mechanism of the resource integration,the medical association is catching the government's attention as time goes on.The current researches on medical association focuses on the medical association mode,the current situation and the development strategy analysis.At present,there are no reports on the quantitative assessment of medical association performance in the literature.Artificial neural network,as an imitate biological neural network structure and function of an information processing system,provides an effective way to deal with nonlinear relationships.More and more methods,based on artificial neural network and its improved comprehensive assessment ways,are applied in practice and show their superiority.Therefore,artificial neural network can be used to analyze the medical association which are composed of multiple agencies and complex organizations.And the method for assessing the performance of medical association can also provide the beneficial reference.Shanghai is one of the major cities for the reform of the medical association in China.The development type of the medical association is diverse,covering a wide range of areas and having great influence.Taking Shanghai as an example,a model based on artificial neural network model was built to assess the performance of the medical association.On the one hand,the research can guarantee sufficient sample sources.On the other hand,it can also be used to understand the development status and reform trend of Shanghai medical association,which is of great practical significance for promoting and deepening the reform of medical association.ObjectivesThe study aims to apply the basic principles of artificial neural network,according to the characteristics of medical association in Shanghai,building the partial least squares-BP neural network model of regional vertical medical association with close cooperation in Shanghai.And through the empirical study,development policy recommendations of medical association in Shanghai are put forward.The specific objectives can be decomposed as follows.Reviewing and commenting on previous literature researches on the medical association.Establishing the index system of the performance assessment of regional vertical medical association with close cooperation in Shanghai.Building the partial least squares-BP neural network model of regional vertical medical association with close cooperation in Shanghai.Through the empirical study,verifying and assessing the performance of selected medical associations of individuals and putting forward related suggestions.ContentsThe research contents can be divided into three parts.The first is retrospective study including the first and the second chapters of the thesis.Through the review of the literature,the two chapters expound the relevant theories involved in the research.The second is to construct the performance assessment index system of regional vertical medical association with close cooperation in Shanghai including the third chapter of the thesis.This chapter mainly discusses how to establish the performance assessment index system of regional vertical medical association with close cooperation in Shanghai through the preliminary literature review and other qualitative and quantitative analysis methods.The third is the modeling and application of the performance assessment of regional vertical medical association with close cooperation in Shanghai including the fourth,fifth and sixth chapters of the thesis.Chapter 4 and chapter 5 mainly expound how to construct the neural network model of the performance evaluation of regional vertical medical association with close cooperation in Shanghai.The sixth chapter mainly discusses how to verify and assess the selected medical associations,and put forward relevant policy suggestions.MethodsBased on the contents mentioned above,the methods involved in the three parts are described as follows.The first part is the retrospective study.The method of literature review was mainly used.Through a large number of literature and the Internet information collections and studies,the background and development of the domestic medical association were analyzed.Due attention on the status quo and progress in the study of performance assessment of the medical association was paid to.The assessment methods and experiences of foreign medical associations or similar organizations were analyzed.The conditions and methods of neural network application in performance assessment were analyzed.At last,the characteristics,methods,current situation and development of the research on the performance assessment of medical association were reviewed.The second part of is construction of the performance assessment index system of regional vertical medical association with close cooperation in Shanghai.This can be divided into two part.First,the theoretical system research of the performance assessment of the medical association.Literature review was used to summarize the definition and classification of the medical association.Then,the theoretical framework of the performance assessment of the medical association was constructed according to the method of "structure-process –outcome" model and the stakeholder analysis.Secondly,it were based on the theoretical framework and the requirements of neural network,expert consultation method and analytic hierarchy process method were applied to establish the performance assessment index system of regional vertical medical association with close cooperation in Shanghai.The third part is the modeling and application of the performance assessment of regional vertical medical association with close cooperation in Shanghai.First,using data from the survey and the National Health and Family Planning Commission Financial Information System,the method of hierarchical partial least-square regression,and the building index system,a data forecasting model was constructed.Simulation was carried out on the part of the missing data and meeting the needs of the neural network modeling.Second,data was collected from 11 qualified regional vertical medical association with close cooperation in Shanghai from 2010 to 2015,with a total sample size of 41 individuals.SIMCA and MATLAB were applied to build the partial least squares-BP neural network performance assessment model of regional vertical medical association with close cooperation in Shanghai.To refer to the medical association performance rating of neural network simulation results and the principles of SMART,the performance assessment rank system of regional vertical medical association with close cooperation in Shanghai was made.Through using the trained neural network,verifying and assessing the performance of selected medical associations of individuals,and putting forward the corresponding policy Suggestions.MaterialsThe research data sources can be divided into three parts.The first is the literature database,including reading all kinds of professional journals,searching database,logging on to the government's official website,Chinese search engines,like Baidu and Sina and so on to obtain the relevant medical policy,statistical data and the latest development of medical association's dynamic information.The second is the National Health and Family Planning Commission Financial Information System,which extracts the basic economic operation and service quantity of the unit from 2010 to 2015.The third is the questionnaire survey data.The relevant data of medical association from 2013-2015 in Pudong new area,including Chuansha,Jinqiao and Waigaoqiao were collected.Results and conclusionsIn this thesis,the theoretical system of the performance assessment of regional vertical medical association with close cooperation in Shanghai was established.Based on the literature review,the definition and classification of medical association were clarified.The present studies of medical association focus on the mode,the present situation and development countermeasure analysis,etc.,and the performance quantitative assessment about medical association hasn't been reported yet in the literature.After research and analysis,the application of partial least squares-BP neural network model can effectively solve the problems that exist in the traditional performance assessment,that are multicollinearity and nonlinear relationship between variables.As a beneficial attempt,it is feasible to assess the performance of medical association by using partial least squares-BP neural network model.Based on the partial least squares-BP neural network model,the performance assessment model of regional vertical medical association with close cooperation in Shanghai was established.After two rounds of expert consultation and analytic hierarchy process,the performance assessment index system of regional vertical medical association with close cooperation in Shanghai was constructed.The index system contains 7 primary indexes,13 secondary indexes and 32 three-level indexes.Combined with the early insider interview,literature data and empirical investigation data,and through the partial least-squares regression analysis of the data simulation,the performance assessment data and information collection were completed.The partial least squares-BP neural network performance assessment model of regional vertical medical association with close cooperation in Shanghai was constructed.The partial least-squares-BP neural network model was used to verify and assess the selected medical associations in Shanghai.Using the classical "SMART" principles,the performance rank of the medical association was divided into four grades: excellent(?8 points),good(?6 points,<8 points),general(?3 points,<6 points),and poor(<3 points).This standard was used to verify and assess the individuals in the medical association.It can be seen that 13 were good,28 were general and the number of excellent and poor were both 0.Therefore,it was concluded that the internal governance structure of regional vertical medical association with close cooperation in Shanghai needs to be further rationalized.The construction of information platform needs to be further improved.A reasonable division of labor coordination mechanism should be established within the medical association.The support of basic medical institutions should be strengthened.The government should strengthen the financial support for the development of the medical association and give full play to the guiding role of health insurance in the development of the medical association.