EQIS1.0 for QALY

EQIS 1.0, a software allows calculating Health Related Quality of Life weights. As health economist, we often concern values for QALYs (Quality Adjusted Life Years).

The website: http://www.econ.unavarra.es/~eqis/Examples.php

USER GUIDE: www.econ.unavarra.es/~eqis/EQIS%201.0%20USER%20GUIDE.pdf

Intro to Health Outcome

I reviewed some websites and literature on health outcome and related measurements today: 

Intro:

http://www.ahrq.gov/clinic/outfact.htm  U.S. Department of Health & Human Services 下辖的 Agency for Healthcare Research and Quality (AHRQ)

http://en.wikipedia.org/wiki/Routine_health_outcomes_measurement  wiki的介绍

List of measurement instruments (工具非常多，有个网页上说有800多种):

http://www.meb.uni-bonn.de/standards/ERGHO/ERGHO_Instruments.html 1994年的，有点老

http://www.outcomes-trust.org/instruments.htm#CHIP 

人体最舒适-温度-湿度-风速-设定

我国国家规定了空气调节标准，对空调温度设定做了规范性的参数：

夏季空调温度设置	温度以24-28°C为宜，相对湿度40%-65%，风速在0.3米/秒以下
冬季空调温度设置	温度以18-22°C为宜，相对湿度40%-60%，风速在0—2米/秒以下

当然，这种规定是指导性的，不同场合、不同功用的房间对空调温度的设定要求也不一样，应具体分析：

青年人卧室：	温度	相对湿度
夏季空调设置	25—29°C	50%—65%
冬季空调设置	20—25°C	50%—60%
病人、老人、小孩卧室：	温度	相对湿度
夏季空调设置	26—27°C	45%—65%
冬季空调设置	22—23°C	40%—60%
客厅以及起居	温度	相对湿度
夏季空调设置	26—28°C	50%—65%
冬季空调设置	22—25°C	40%—55%

source： http://www.foxiangwang.com/994.html

payment reform and a JAMA paper

麻省实施了一个a global payment system called the Alternative Quality Contract (AQC)后一年里，对费用和服务质量的影响，分析用的是individual data，采用了前后测量和DD方法。--真是漂亮啊！这是这期JAMA上宋zirui一篇文章，虽然他还没拿到PhD，但是文章级别水平那真是~~~没的说！

Last month I joined a provincial workshop which discussed how to implement payment reform by conducting a combination of "Shanzhai DRG" for inpatient care and a global payment for outpatient care, since then I was just wondering how to evaluate effects of those payment reform.

Song Z, Safran D G, Landon B E, He Y, Ellis R P, Mechanic R E, Day M P and Chernew M E 2011 Health Care Spending and Quality in Year 1 of the Alternative Quality Contract New Engl J Med  null-null

好医院是由医生领导？

在欧美的趋势是医院公司化，领导职业经理人化（没有医学相关学位的人领导）。国内离这一步还差远吧，医生联盟统治的医院几乎是滴水不漏的。现在有文章检验欧美的趋势，但是结论离因果效应还差得远吧。

Top-performing hospitals are typically ones headed by a medical doctor rather than a manager. That is the finding from a new study of what makes a good hospital.

Its conclusions run counter to a modern trend across the western world to put generally trained managers — not those with a medical degree — at the helm of hospitals. This trend has been questioned, particularly by the Darzi Report, which was commissioned by the U.K. National Health Service, but until now there has been no clear evidence.

Amanda Goodall PhD, at the Institute for the Study of Labor (IZA) in Bonn, Germany, constructed a detailed database on 300 of the most prominent hospitals in the United States. She then traced the professional background and personal history of each leader. The research focused particularly on hospital performance in the fields of cancer, digestive disorders and heart surgery.

The study shows that hospital quality scores are approximately 25% higher in physician-run hospitals than in the average hospital.

Goodall stressed that more research would be needed before cause-and-effect could be truly understood. The study, a cross-sectional one, uses data from 2009. "This is an intriguing pattern but these snap-shot results for a single point in time do not prove that doctors make the best heads of hospitals, although they are consistent with that claim. More research following a range of hospitals through time is urgently needed," she said.

"Physician-Leaders and Hospital Performance: Is There an Association?", by Amanda H. Goodall, is in press at Social Science and Medicine. It can be downloaded free of charge as from the IZA website (www.iza.org) as IZA Discussion Paper No. 5830:http://ftp.iza.org/dp5830.pdf