【正文】 ther positive effectiveness index can be obtained by bining the rest metrics, then the ratio of two positive indexes named coseeffectiveness can represent whether the system is better than others. Part Ⅱ : Identify current sources of data As mentioned above, the number of metrics is more than 70 in the World Health Statistics given by the WHO, it is nearly impossible for us to evaluate a health care system using all of them. On the other hand, some of the metrics which we must use can not be obtained from the statistical data published directly, the only way to solve this problem is to identify the useful data and then modify them. Identifying data To insure the availableness of the chosen metrics, we need to relate the chosen metrics with the current sources of data. Identifying data about mortality For mortality, the data such as life expectancy, infant mortality rate, neonatal mortality rate and maternal mortality rate can be acquired from the World Health Statistics directly, thus the data mentioned above should be identified. Identifying data about typical epidemic morbidity However, there is no existing data about the mortality rate of typical epidemic sufferer, which means we have to calculate it using the available data. In most cases, the typical epidemic diseases can be represented by AIDS and tuberculosis, because the mortality of AIDS represents the treatment of epidemic diseases while the mortality of tuberculosis represents the controlment of them. Thus the HIV/AIDS mortality rate and TB mortality rate should be chosen. As mentioned above, the typical epidemic diseases can be substituted by AIDS and TB. Then the HIV prevalence among adults aged 15 years and TB prevalence can be used to present the typical epidemic morbidity. Identifying data about coverage For the proportion of the population without hospitalization insurance dependents on the financial input of a country to a great extent, which will be discussed in the health systems expenditure, the only change in this part is to ignore its effect. Thus the identified data in this part are: immunization coverage, antenatal care coverage and contraceptive prevalence rate. Identifying data about health systems resource The health systems resources include both human and material resources, based on the available data, the density of physicians, nurses, etc. and hospital beds per 1000 population should be chosen. Identifying data about health systems expenditure For all of the data about health systems expenditure can be obtained from the World Health Statistics directly, we don’t need to change any of them, which means 第 6 頁 共 26 頁 the data identified in this part are: total expenditure on health as % of GDP, government and private expenditure on health as % of total expenditure on health and per capita total expenditure on health. Identifying data about inequalities Generally speaking, the person who lives in the city with the higher wealth and educational level may receive the better health service. This can represent one aspect of inequalities. However, to describe the inequalities in detail, we choose the data shown in table 3. Concluding the identified data To take on the result of identified data more distinctly, we concluded them in one table (refer to table 3) Modifying the metrics Even though all the identified data could be obtained from the World Health Statistics, we still need to modify some of them to make the metrics more useful. Table 3. Data Identified from World Health Statistics 2021 Combined Data Identified mortality Life expectancy Infant mortality rate Neonatal mortality rate Maternal mortality ratio HIV/AIDS mortality rate TB mortality rate morbidity HIV prevalence among adults aged15 year TB prevalence coverage Immunization coverage among 1yearsolds Antenatal care coverage Contraceptive prevalence rate Health systems resource Density of physicians、 nurses， etc hospital beds per 1000 population Health systems expenditure Total expenditure on health as %of GDP Government and Private expenditure on health as %of Total expenditure on health Per capita total expenditure on health Inequities Probability of dying aged 5 years per 1000 live births ratio of ruralurban ratio of lowesthighest Wealth ratio of lowesthighest Educational level Children aged 5 years stunted for age ratio of ruralurban ratio of lowesthighest t Wealth ratio of lowesthighest Educational level Births attended by skilled health personnel ratio of ruralurban ratio of highestlowest Wealth ratio of highestlowest Educational level Measles immunization ratio of ruralurban 第 7 頁 共 26 頁 coverage among 1yearolds ratio of highestlowest Wealth ratio of highestlowest Educational level Comparing table1 with table 4, the typical epidemic morbidity is replaced by HIV prevalence among adults aged15 years and TB prevalence. What’s more, the integrated inequality is also replaced by inequalities representing in different regions and different people, which means the typical epidemic morbidity and inequalities need to be modified. Symbols used in part Ⅱ Table 4. The Symbols Used in Part Ⅱ Symbols Definition Unit EM Total number die of epidemic diseases per 100,000 population people AEM Number of people die of AIDS per 100,000 epidemic patients people TEM Number of people die of TB per 100,000 epidemic patients people TM Number of people die of TB per 100,000 TB patients people TP Number of people infected TB per 100,000 population people HM Number of people die of AIDS per 100,000 AIDS patients people HP Number of people infected AIDS per 100,000 population people ir Rate that represent each inequality ( 122,1 ??i ) Modifying the typical epidemic morbidity