摘要
2002年10月-2003年8月,笔者作为同济大学投资研究所“社会资本参与公立医院产权制度改革的制度创新与实践突破”课题组主要成员,参与了苏州市第四人民医院改制课题的研究。对该课题的研究,引发了笔者对我国医疗卫生体系模型和改革政策的深入思考,并将之作为本博士论文的研究题目。
从世界范围来看,近年来,无论是以政府福利为主还是以市场机制为主的医疗保障体制,都暴露出其不完善的弊端,医疗卫生改革已成为全球性话题。
我国医疗卫生改革正处于体制大转轨、结构大调整的关键时刻。医疗卫生改革何去何从,成为人们探讨的热点话题。
根据政府和私人在医疗卫生体系中的作用、范围和具体实现形式,世界各国医疗卫生体系模式大体可以分为四个类型:以英国为代表的政府主导型、以美国为代表的市场主导型、以德国为代表的社会保险型和以新加坡为代表的公私互补均衡型。本论文对这四种模式进行了总结和评价,得出这四种模式的医疗卫生体系模型。
在此基础上,笔者运用系统科学的方法,进行了理想的国家医疗卫生体系模型设计,以期为我国建立科学、合理,且符合我国具体国情的医疗卫生体系提供指导。
为了建立我国医疗卫生体系模型,本论文回顾了我国医疗卫生体系的历史沿革概况,从中了解我国医疗卫生体系改革的历史进程和政府决策所起的作用;分别对计划经济时期和改革开放时期,我国医疗体系发展的经验和教训进行了总结;通过对当前医疗改革困局的外在表现、内在动因的分析,解析了我国当前医疗困局;根据国务院研究机构的研究报告指出了我国医疗卫生改革的政策倾向。
在国内外研究现状总结、国外医疗卫生模型评述和我国医疗卫生体系历史沿革和改革状况分析的基础上,本论文进而按照理想的国家医疗卫生体系的模型的要求,结合我国的实际情况,研究得出了由医疗卫生组织体系和医疗卫生保障体系两大模块组成的我国医疗卫生体系模型,并根据理想的模型对照系统设计目标对其进行了公平性、可及性、效率、政府财政负担和患者经济负担等指标的评价与检验。
我国地域广阔,各地区医疗卫生状况及经济社会发展的其他诸方面存在显著的差异性。根据系统理论,当系统运行过程中受到相关因素的干扰时,须对系统进行补充和修正。因此本论文根据各地区不同的医疗需求(和需要)状况和卫生资源的供给现状,综合运用多种统计方法,建立了卫生资源配置模型,作为我国医疗卫生体系的子模型,对我国医疗卫生体系模型进行必要补充和修正。
As a key member of the research team on the topic of Policy Innovation and Practice Renovation on Public Hospital Property System Reform with Social Capital Involved, in Investment Research Institute, Tongji University, during October 2002 to August 2003, the author worked on the project of Reform of No. Four Hospital, Suzhou. This research caused the author's deep ponder upon the model and reform policy of China's medical and health care system, which finally became the topic of this dissertation.Looking in the scope of the whole world, we can find that in resent years, both the government and market dominating health care system have exposed problems of imperfection. Reform on medical and health care system has turned out to be a global topic.China's medical and health care reform is now on the turning point. Where to go is just warmly discussed.According to the function, range and implementing means, the medical and health care systems in the world can be summarized into four types - UK's government dominating, US's government dominating, Germany's social insurance and Singapore's public and private collaborating types. The dissertation examined and summarized these four types of systems and formed models of each.On the ground of those models and by applying system methodology, the dissertation raised an ideal model of state medical and health care systems, for the purpose of indicating the establishing the scientific, reasonable and suitable system in our country.Based on the previous analysis and conclusion, the dissertation further developed the model of China's medical and health care system in the guidance of the ideal model, which was made up of two modules of medical and health care organization system and health care ensuring system. And made evaluation and testing according to the objectives of the ideal model, in aspects of fairness, accessibility, efficiency and the affordability both of the government and individuals.Thanks to the vast territory of China and the large difference on medical and health care condition and other fields of economy and society between different regions, the dissertation worked out the model of health resource allocation as necessary complements and modification to the model of China's medical and health care system given by the previous section, according to the system theory about disturbing factors and by using various statistic methods.At the end of the dissertation, the author got a chance to restate the major conclusion and deficiencies, and also to look into the future for further study.
The innovations carried out in the dissertation are:a. The dissertation raised an ideal model of state medical and health care systems after examining and summarizing the four types of medical and health care systems in the world by applying system methodology;b. Based on overseas experiences and lessons and domestic practice, the dissertation further developed the model of China's medical and health care system in the guidance of the ideal model;c. The dissertation worked out a sub-model of health resource allocation as necessary complements and modification to the model of China's medical and health care system due to the large difference on medical and health care condition and other fields of economy and society between different regions in China's vast territory.
引文
[1] 王陇德.中国卫生体制改革.CPA中国行政管理,2004(8)
[2] 杜石然等.《中国科学技术史稿》.北京:科学出版社,1982,103-104
[3] 《中国企业管理百科全书》上册,北京:企业管理出版社,1884:29-30
[4] 沈小峰、胡岗、姜璐.《耗散结构论》.上海:上海人民出版社,1987
[5] G·尼科利斯,I.普里戈京.徐锡申等译.《非平衡系统的自组织》.北京:科学出版社,1986
[6] H·哈肯.徐锡申等译.《协同学——引论物理学、化学和生物学中的非平衡相变和自组织》.原子能出版社,1984
[7] 中国大百科全书出版社编辑部编《中国大百科全书咱动控制与系统工程》,北京:中国大百科全书出版社,1991
[8] Ludwig von Bertalanffy, General system theory: foundations, development, applications. George Braziller, 1968
[9] 《韦氏大词典》
[10] 刘余善,谷宝贵.《实用管理系统工程》.杭州:浙江人民出版社,1987:p.18
[11] 康聚秋主编.《工业管理系统工程》.长春:吉林人民出版社,1986:p.4
[12] 钱学森等.论系统工程.长沙:湖南科学技术出版社,1982
[13] A.D. Hall, Three-dimensional morphology of systems engineering, IEEE Transactions on Systems, Man, and Cybernetics, vol. SMC-5, no. 2, April 1969, pp. 156-160.
[14] 中国人民大学管理系统工程教研室.《管理系统工程:现代管理的方法和应用》.国防工业出版社,1983:p.13
[15] P. Checkland, Systems Thinking, Systems Practice; John Wiley, 1981
[16] 霍绍周.《系统论》.北京:科学技术文献出版社,1988
[17] L·贝塔兰菲著,秋同,袁嘉新翼译.《一般系统理论》.北京:社会科学文献出版社,1987:p.46
[18] 李特尔(I.M.D.Little).《福利经济学评述》.北京:商务印书馆,1965
[19] 霍布森.《帝国主义》.伦敦,1938:p.86
[20] 姚明霞.《福利经济学》.北京:经济日报出版社,2005
[21] 亚当·斯密.《国民财富的性质及其原因的研究》.伦敦丹特公司,1955:p.246
[22] 奥肯.《平等与效率》.王奔洲译,北京:华厦出版社,1987
[23] 哈耶克.《法律、立法和自由》第2卷.芝加哥,1976:p.142
[24] Milton Friedman, Capitalism and Freedom: Fortieth Anniversary Edition, University of Chicago, 2002
[25] 劳尔斯.《正义理论》.哈佛大学出版社,1971
[26] 勒纳.《统制经济学:福利经济学原理》.北京:商务印书馆,1965
[27] 布坎南.《自由、市场和国家》,中译本,北京:北京经济学院出版社,1989:140-141
[28] 萨缪尔逊,诺德豪斯.《经济学》英文第13版,p.46
[29] Victor R.. Fuchs(a), (1999), The Future of Health Economics ,NBER working paper, no.7379, 3-5.
[30] Arrow, K.J. (1963), Uncertainty and the welfare economics of medical care, American Economic Review, vol.53: 5, 941-973.
[31] Victor R. Fuchs(b), (1982), Economic Aspects of Health, Chicago: Chicago Press, 12-15.
[32] Michael Grossman, (1972), The Demand for Health: A Theoretical and Empirical Investigation, New York: Columbia University Press For The National Bureau of Economic Research, 3-10.
[33] Michael Grossman and Theodore Joyce, (1988), Unobservable, Pregnancy Resolutions, & Birthweight Production Functions in New York City, NBER working Paper, No2746, 26-30.
[34] 约翰·G·库里斯和皮·A·威斯特.《卫生经济学概论》,北京医学院卫生经济学研究会译,北京:中国展望出版社,1983.4:118-119
[35] Joseph P. Newhouse, (1970), Toward A Theory Nonprofit Institutions, American Economy Review, vol.60, 604-713.
[36] Mark V. Pauly, (1987), Nonprofit Firms in Medical Markets, American Economic Review, Vol.77, no.2, 257-274.
[37] Kristian Bolin et al., (2000), The family as the health producer-when spouses are Nash-bargalners, Journal of Health Economics, vol.20, 349-362.
[38] Gruber Jonathan, (1996), Saving Babies: The Efficacy & Cost of Recent Changes In The Medical Eligibility of Pregnant Women. Journal of Political Economy, vol. 104, 1261-1296.
[39] Mushkin, S. J., (1962), Health as an investment, Journal of Political Economy, vol.70, 252-263
[40] Anni A. Scitovsky, (1967), Changes in The Cost Treatment of Selected Illnesses, 1956-65, American Economy Review, vol.57, no.5, 1183-1195
[41] Frans Rutten et al., (2001), Book Review Handbook of Health Economics, Journal of Health Economics, vol.20, 855-879.
[42] Dolan P., (2000), The Measurement of Health-Related Quality of Life. Handbook of health economics, edited by Anthony J. Culyer and Joseph P. Newhouse, New York: Elsevier, vol.1B, 1749-1755.
[43] Phelps, C.E. (1997), Health Economics, New York, NY: Addison-Wesley Educational Publishers Inc.
[44] Gaynor, M and W.B Vogt (2000), Antitrust and competition in health care markets, Chapter 27 in A.J. Culyer, J.P. Newhouse, eds., Handbook of Health Economics, 1B, 1405-1487, North Holland: Elsevier Science.
[45] McGuire, T.G. (2000), Physician agency, Chapter 6 in A.J. Culyer, J.P. Newhouse, eds., Handbook of Health Economics, 1A, 461-536, North Holland: Elsevier Science.
[46] Dranove, D., M.Shanley, and W.D.White (1993), Price and concentration in hospital markets: the switch from patient-driven to payer-driven competition, Journal of Law and Economics, 36, 179-204.
[47] Salkever, D.S. (2000), Regulation of price and investment in hospitals in the U.S., Chapter 28 in A.J. Culyer, J.P. Newhouse, eds., Handbook of Health Economics, 1B, 1489-1535, North Holland: Elsevier Science.
[48] Sloan, F.A. (2000), Not-for-profit ownership and hospital behavior, Chapter 21 in A.J. Culyer, J.P. Newhouse, eds., Handbook of Health Economics, 1B, 1141-1174, North Holland: Elsevier Science.
[49] 周子君,冯文等.国有医院管理体制改革探讨.中华医院管理杂志,2003,19(2):74-77
[50] Bays, C.W. (1983), Why most private hospital are nonprofit, Journal of Policy Analysis and Management, 2, 366-385.
[51] Hart, O., A. Shleifer, and R.W.Vishny (1997), The proper scope of government: theory and an application to prisons, Quarterly Journal of Economics, 112: 4, 1127-1162.
[52] Gertler, P. (1998), On the road to social health insurance: the Asian experience, World Development, 26:4, 717-732.
[53] Frech, H.E.III (1976), The property rights theory of the firm: empirical results from a natural experiment, Journal of Political Economy, 84, 143-152.
[54] Pauly M.V. and M. Redisch (1973), The not-for-profit hospital as a physician's cooperative, American Economic Review, 63, 87-99.
[55] Duggan, M.G. (2000), Hospital ownership and public medical spending, Quarterly Journal of Economics, 115: 4, 1343-1373.
[56] Culter, D.M.(2000), Introduction, in D.M. Culter, eds., The Changing Hospital Industry: Comparing Not-for-Profit and for-Profit Institution, Chicago: The University of Chicago Press.
[57] Becker, F.R. and F.A. Sloan (1985), Hospital ownership and performance, Economic Inquiry, 23, 21-36.
[58] Keeler, E.B., L.V. Rubinstein, and K.L. Kahn (1992), Hospital characteristics and quality of care, Journal of the American Medical Association, 268: 13, 1709-1714.
[59] Shortell, S. and E.F.X. Hughes (1988), The effect of regulation, competition, and ownership on motality rates among hospital inpatients, New England Journal of Medicine, 318: 7, 1100-1107.
[60] Hoerger, T.J. (1991), Profit variability in for-profit and not-for-profit hospital, Journal of Health Economics, 10, 259-289.
[61] Lynk, W.J. (1995), Nonprofit hospital mergers and the exercise of market power, Journal of Law and Economics, 38, 437-461.
[62] Cutler, D.M. and J.R. Horwitz (2000), Converting hospital from not-for-profit to for-profit status: why and what effects?, in D.M. Culter, eds., The Changing Hospital Industry: Comparing Not-for-Profit and for-Profit Institution, Chicago: The University of Chicago Press.
[63] Bitran R. 1995. Efficiency and quality in the public and private sectors in Senegal. Health Policy and Planning 10(3): 271-283
[64] Kanji N, Kilima P, Lorenz N, Garner P. 1995. Quality of primary outpatient services in Dar-es-Salaam: a comparison of government and voluntary providers. Health Policy and Planning 10(2):186-190.
[65] Mills A, Hongoro C, Broomberg J. 1997. Improving the efficiency of district hospitals: is contracting an option? Tropical Medicine and International Health 2(2): 116-126.
[66] Gilson L. 1995. Management and health care reform in sub-Saharan Africa. Social Science and Medicine 40(5): 695-710.
[67] Mudyarabikwa O, Madhina D. 2000. An assessment of incentive setting for participation of privatefor-profit health care providers in Zimbabwe. Small Applied Research No. 15. Partnerships for Health Reform Project, Abt Associates Inc: Bethesda, MD.
[68] Robinson, J.C. and H.S. Luft (1985), The impact of hospital market structure on patient volume, average length of stay, and the cost of care, Journal of Health Economics, 4: 4, 333-356.
[69] Melnick, G., J. Zwanziger, A. Bamezai, and R. Pattison (1992), The effects of market structure and bargaining position on hospital prices, Journal of Health Economics, 11, 421-447.
[70] Noether, M. (1988), Competition among hospitals, Journal of Health Economics, 7:3, 259-284.
[71] Keeler, E.B., G. Melnick, and J.Zwanziger (1999), The changing effects of competition on non-profit and for-profit hospital pricing behavior, Journal of Health Economics, 18, 69-86.
[72] Kessler, D.P. and M.B. McClellan (2000), Is hospital competition socially wasteful? , Quarterly Journal of Economics, 577-615.
[73] Dranove, D. and M.A. Satterthwaite (2000), The industrial organization of health care markets, Chapter 20 in A.J. Culyer, J.P. Newhouse, eds., Handbook of Health Economics, 1B, 1093-1139, North Holland: Elsevier Science.
[74] Allen, R. (1992), Policy implications of recent hospital competition studies, Journal of Health Economics, 11,347-351.
[75] Cutler, D.M. and R.J. Zeckhauser (2000), The anatomy of health insurance, Chapter 11 in A.J. Culyer, J.P. Newhouse, eds., Handbook of Health Economics, 1A, 563-643, North Holland: Elsevier Science.
[76] Hodgkin, D. and T.G. McGuire (1994), Payment levels and hospital response to prospective payment, Journal of Health Economics, 13, 1-29.
[77] Pauly, M. (2000), Insurance reimbursement, Chapter 10 in A.J. Culyer, J.P. Newhouse, eds., Handbook of Health Economics, 1A, 537-560, North Holland: Elsevier Science.
[78] Sloan, F.A. and B. Steinwald (1980), Effects of regulations on hospital costs and input use, Journal of Law and Economics, 23, 81-109.
[79] Dranove, D. and K. Cone (1985), Do state rate setting regulations really lower hospital expense?, Journal of Health Economics, 4: 2, 159-166.
[80] Salkever, D.S. and T.W. Bite (1976), The impact of certificate of need controls on hospital investment, Milbank Memorial Fund Quarterly: Health and Society: Spring, 185-214.
[81] Sloan, F.A. (1981), Regulation and the rising cost of hospital care, The Review of Economics and Statistics, 63: 4, 479-487.
[82] 丁涵章等主编.《现代医院管理全书》.杭州:杭州出版社,1999
[83] 史自强等主编.《医院管理学》.上海:上海远东出版社,1995
[84] 张鹭鹭.转型时期医院可持续发展的分析与思考.中华医院管理杂志,2002,Vol.18(7):385-386
[85] 张鹭鹭.转型期医院可持续发展的资源结构.中华医院管理杂志,2003,Vol.19(2):90-91
[86] 张鹭鹭.转型时期医院可持续发展机制实证研究.中华医院管理杂志,2003,Vol.19(2):87-89
[87] 白常凯,张鹭鹭等.转型期医院科技进步综合评价.中华医院管理杂志,2003,Vol.19(2):98-99
[88] 中国卫生总费用研究课题组.中国卫生总费用分配流向研究报告(1978-1995).中国卫生经济,1996,Vol.15(12):22-26
[89] 赵郁馨等.全国部分地区卫生总费用调查分析.中国卫生经济,1997,Vol.16(9):20-22
[90] 卫生部卫生经济研究所.中国卫生总费用研究报告(1990-1995).中国卫生经济,1997,Vol.16(12):34-37
[91] 中国卫生费用核算小组.中国卫生总费用历史回顾和发展预测(1978-2010).卫生软科学,2000,14(5):202-213
[92] 杜乐勋.漫谈如何利用卫生总费用数据进行政策分析.卫生经济研究,2000,(6):5-8
[93] 赵郁馨、高广颖、杜乐勋.中国卫生总费用发展变化趋势及其影响因素.卫生经济研究,2001,(1):7-9
[94] 赵郁馨.卫生总费用运行特点及增长因素.中国卫生经济,2002,Vol.21(3):32-35
[95] 赵琨等.中国卫生总费用测算报告.中国卫生经济,2002,Vol.21(3):29-32
[96] 赵郁馨等.2001年中国卫生总费用侧算与分析.中国卫生经济,2003,Vol.22(3):1-3
[97] 赵郁馨等.2002年中国卫生总费用侧算与分析.中国卫生经济,2004,Vol.23(3):5-10
[98] 丁汉生、胡善联.我国卫生资源分部公平性研究.中国卫生事业管理,1994,(2):105-107
[99] 李刚等.区域人群相对医疗服务需要的测量方法及其在卫生资源配置中的应用研究.中国卫生资源,2001,Vol.4(5):225-229
[100] 张鹭鹭、胡善联.医院医疗服务供给的经济学实证研究概述.中华医院管理杂志,2002,Vol.16(5):261-263
[101] 张鹭鹭、胡善联.区域内医院卫生资源配置公平性研究.中华医院管理杂志,2002,Vol.16(5):274-277
[102] 张鹭鹭、胡善联.区域内医院卫生资源供给现况分析.中华医院管理杂志,2002,Vol.16(5):264-266
[103] 张鹭鹭、胡善联.区域内医院医疗服务供给系统效率研究.中华医院管理杂志,2002,Vol.16(5):272-274
[104] 崔树田.当前医疗卫生体制机制改革的特点和展望.中国卫生事业管理,2001(8):458-459
[105] 杜乐勋.关于国有医院产权制度转化和治理结构问题.中国医院管理,2003,Vol.23(7):5-6
[106] 林丽霜.公立医院产权多元化的思考.温州医学院学报,2002,Vol.32(3):204-205
[107] 李国庆,徐连英.论我国医院的产业化经营.中国医院管理,2003,Vol.23(3):54-55
[108] 李吾尔等.浅论我国医院产权制度改革的发展方向.中国医院管理,2003,Vol.23(3):4-5
[109] 范关荣.公立医院改革中两权分离理论和实践探索.中国医院,2004,Vol.8(6):5-7
[110] 陈曙光等.公立医院管理体制改革和运行机制改革调查分析.中国卫生事业管理,2003(6):325-326
[111] 张英.公立医院产权制度改革的十个问题.现代医院,2005,Vol.5(1):9-11
[112] 郝模等.公立医疗机构管理体制改革:策略和障碍.中国医院管理,2004,Vol.24(1):2-6
[113] 夏金彪.“郎顾之争”波及医院改制 卫生部低调产权改革.中国经济时报,2005.1.13
[114] 国务院发展研究中心课题组.对中国医疗改革的评价与建议,2005.7
[115] 郭清等.医院吸收社会资本的可行性研究.中国卫生经济,2004,Vol.23(3):60-62
[116] 王力扬.公立医院引入社会资本分析.医院管理论坛,2004(3):13-15
[117] Henry J. Aaron (2001), Book Review Handbook of Health Economics, Journal of Health Economics, vol.20, 847-854; supplement, 129-157.
[118] Agion Japhson, The problem of NHS [J]. Academic Jounal of St James's Hospital, 2001,7(5): 343-345
[119] 李素珍编译.英国国家卫生服务制度九十年代改革回顾.国外医学卫生经济分册,2000,Vol.17(1):15-18
[120] 龚向光,胡善联.英国医院体制改革.卫生经济研究,2003(3):20-22
[121] 汤晓莉.英国国家卫生服务制度的起源及几次重大改革.中国卫生资源,2001,Vol.4(6):279-282
[122] Epstein A M, US teaching hospitals in the evolving health care system, JAMA, 1995, vol. 273:1203
[123] William C. Coekerham, Medical Sociology, published by Prentice HALL, 1998
[124] Brown, L D. Exceptionalism as the Rule? U.S. Heath Policy Innovation and Cross-National Learning. Journal of Heath Politics, Policy and Law, 1998, 23(1): 35-51
[125] Jaklevie M (2002).Tired trend. Modern Healthcare. 32(26):10
[126] Lesser C and Ginsburg P (2001). Back to the future? New cost and access challenges emerge: initial findings from HSC's recent site visits, Issue brief #35. Center for Studying Health Systems Change
[127] Victor R Funchs, Managed care and merger mania, JAMA, 1997, vol. 277:920
[128] Heath Care Study Group. Understanding the Choices in Health Care Reform Journal of Health Politics, Policy and Law, 1994, 19(3): 499-541
[129] 周云.从国外医疗保障制度看市场与政府的作用.国外医学卫生经济分册,2003,vol.20(4):151-154
[130] 龚向光,胡善联.德国医院体制改革.卫生经济研究,2001(7):32-33
[131] European Observatory on Health Care Systems, Health Care System in Transition to Germany, 2000. 1283.
[132] 于涛.综述:德国医疗体制改革经验初探.中国金融网 http://www.zgirw.com 2005/8/17
[133] 毛圣昌编译.德国社会医疗保险改革趋势.国外医学卫生经济分册,2002,vol.19(3):126-130
[134] 蔡仁华.新加坡医疗保障制度述评.卫生经济研究,1994(10):40-46
[135] Ministry of Health. Affordable health care: a white paper. Singapore: SNP Publishers, 1993
[136] 孙力军,王瑛.新加坡、韩国和台湾地区卫生体制改革比较.中国卫生资源,2002,Vol.5(2):86-88
[137] 任伯平等著。《管理系统工程》.太原:陕西人民出版社,1986:72-79
[138] 中国医改20年.南方周末2005.8.4
[139] 卫生部.国家卫生服务研究1998年第二次国家卫生服务调查分析报告
[140] Santerre, R.E. and S.P. Neun (1996), Health Economics: Theories, Insights, and Industry Studies, Chicago: Irwin.
[141] 包章炎等.民营医院发展研究.卫生经济研究,2002(7):5
[142] 徐轶.民营医院何以生机勃勃.中国卫生经济,2002(21):48
[143] 曲江斌等.市场经济转轨时期的政策与民营医疗机构发展.中国卫生经济2004;Vol.23(9)8-10
[144] 上海市疾病预防控制中心.癌症的社区医疗和社区康复.上海卫生,http://www.smhb.gov.cn,2004/04/18
[145] 徐充,朱艳.我国城镇居民贫困问题的对策思考.社会科学家,2005(1)41-44
[146] 杨海文,於怡.农村新型合作医疗保险制度中筹资机制研究.中南财经政法大学学报,2005(1):42-44
[147] 黄如欣.医疗服务市场需求的特点.中国医院管理,2003:Vol.23,268(11):41-42
[148] 饶克勤,陈育德.关于制订卫生资源配置标准的几点建议.中国卫生经济,1999:Vol.18(3):37-42
[149] 王学民.《应用多元分析》.上海:上海财经大学出版社,1999:237-267
[150] Norusis, M. 2004. SPSS 13.0 Guide to Data Analysis. Upper Saddle-River, N.J.: Prentice Hall, Inc..