ارزیابی کارایی فنی مراکز خدمات جامع سلامت شهری همدان با استفاده از روش تحلیل پوششی داده‌ها (DEA) در سال 1398
محورهای موضوعی : -اقتصاد بهداشت و درمان
محمد یوسفی نیر
1
(کارشناس‌‌ارشد ،گروه مدیریت و اقتصاد بهداشت، دانشکده بهداشت، دانشگاه علوم پزشکی همدان، همدان، ایران)
علی اکبر فضائلی
2
(استادیار، گروه مدیریت و اقتصاد بهداشت، دانشکده بهداشت، دانشگاه علوم پزشکی تهران،تهران، ایران)
ید اله حمیدی
3
(استاد، گروه مدیریت و اقتصاد بهداشت، دانشکده بهداشت، دانشگاه علوم پزشکی همدان، همدان، ایران)
جلا ل الدین امیری
4
(استادیار کودکان، گروه اطفال، دانشکده پزشکی، بیمارستان بعثت، دانشگاه علوم پزشکی همدان، همدان، ایران)
کلید واژه: کارایی فنی, مراکز خدمات جامع سلامت, تحلیل پوششی داده‌ها,
چکیده مقاله :
مقدمه: مراکز بهداشت درمانی شهری یکی از مهم ترین مراکز ارائه دهنده خدمات اولیه سلامت هستند که با توجه به گستردگی مراکز و تعداد خدمات، بخش قابل ملاحظه ای از منابع نظام سلامت جامعه به این مراکز اختصاص می‌یابد.بنابراین تعیین و پایش مستمر کارایی این مراکز می‌تواند نقش بسزایی در بهبود کارایی منابع سلامت و جلوگیری از هدررفتن منابع داشته باشد. هدف از انجام این مطالعه، ارزیابی کارایی فنی مراکز خدمات جامع سلامت شهری همدان در سال 1398بوده است روش پژوهش: این مطالعه توصیفی - تحلیلی به بررسی کارایی 19 مرکز خدمات جامع سلامت شهری همدان با استفاده از روش تحلیل پوششی داده‌ها (DEA) پرداخته است. نهاده‌های مدل شامل تعداد پزشک و تعداد کارکنان ماما، بهیار و کارشناس مبارزه با بیماری‌ها ،ستانده‌ها نیز شامل تعداد معاینه توسط پزشک، خدمات مامایی، واکسیناسیون و تزریقات و پانسمان می‌باشد.در این پژوهش از نرمافزار Deap2.1 استفاده شده است. یافته‌ها: در سال 1398 میانگین کارایی فنی مراکز خدمات جامع سلامت مورد مطالعه 0.751، میانگین کارایی مدیریتی 0.85 و میانگین کارایی مقیاس به میزان0.88به دست آمد. از کل مراکز خدمات جامع سلامت مورد مطالعه، 6 مرکز دارای کارایی فنی 1و 13 مرکز دارای کارایی فنی کمتر از 1 می‌باشد. نتیجه‌گیری: در مراکزی که دارای کارایی کمتر از 1 می‌باشند مقادیر اولیه و بهینه باهم متفاوت و مازاد نهاده وجود داشت. از اینرو پیشنهاد می‌شود مراکز مذکور، در حد امکان مقادیر مازاد نهاده‌های خود را کاهش دهند تا بتوانند به حداکثر کارایی دست پیدا کنند.
Introduction:Urban health centers are one of the most important centers for providing primary health services. According to the wide range of health centers and the number of services provided by these centers, a significant portion of the community health system resources are allocated to these centers; therefore, the determination and continuous monitoring of the effectiveness of these centers can play a significant role in improving the efficiency of health resources and preventing waste of resources. The purpose of this study Assessment of Technical Efficiency of Comprehensive Health Services Centers of Hamadan by Data Envelopment Analysis (DEA) in 2019. Methods: This descriptive-analytic study evaluates the effectiveness of Hamedan comprehensive health centers services using the data envelopment analysis method. Inputs include: number of physicians and number of employees (midwife, specialist in the fight against diseases.). Outputs include: number of examinations by physician, midwifery services, vaccinations, injections and dressings. Results: In 2018 the average technical efficiency of the comprehensive health services centers was 0.751, the mean management efficiency was 0.85 and the mean efficiency of the scale was 0.88. Of the total centers of comprehensive health services surveyed, 6 centers have technical capacity of 1 and 13 centers with a technical efficiency of less than 1. Conclusion: In centers with efficiency less than 1, there were initial and optimal values of the same and different inputs. Therefore, it is suggested that these centers reduce their inputs as much as possible so that they can achieve maximum efficiency.
1- Siciliani L. Estimating technical efficiency in the hospital sector with panel data. Applied Health Economics and Health Policy, 2006; 5(2): 99-116.
2- Hsiao B, Chen LH, Wu HT. Assessing performance of Taiwan hospitals using data envelopment analysis: In view of ownership. The International journal of health planning and management, 2019; 34(1): e602-e16.
3- MofarahZat A, Fazaeli AA, Hamidi Y. Study of socioeconomic factors affecting tuberculosis and its cost in Hamadan province. Hospital, 2020; 19(1): 9-16.
4- Emamrezaei A BM. Efficiency analysis of hospitals in Iran: A systematic review Payesh, 2016;16(1).
5- Shadpour K. Primary health care networks in the Islamic Republic of Iran. Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit, 2000; 6(4): 822-5.
6- Ahmad Kiadaliri A, Najafi B, Haghparast-Bidgoli H. Geographic distribution of need and access to health care in rural population: an ecological study in Iran. International Journal for Equity in Health, 2011; 10(1): 39.
7- Farahabadi m Ym, Bahmanziari n, Fazaeli s. Efficiency Analysis of Selected Urban Health Centers of Isfahan University of Medical Sciences. hospital, 2011; 10(1): 35-43.
8- Shoja n Aa, Khalili n. Performance Evaluation of Healthy Houses in Firouzkouh City Using Data Envelopment Analysis. economical modeling, 2014; 8(3): 53-69.
9- Azar A, Valipour khatir M, Moghbel baerz A, Hasas yeganeh Y. Evaluation of Hospital Efficiency by Data Envelopment Analysis: Tehran University of Medical Sciences: (2009-2011). Journal of Health Administration, 2013; 16(53): 36-46.
10- Zare Ahmadabadi H, Masoudian S, Zare Banadkouki MR. Evaluating the technical efficiency of Yazd City health centers with a combined approach of DEA and GT. The Journal of Shahid Sadoughi University of Medical Sciences, 2019; 26(8): 717-32.
11- Akazili J, Adjuik M, Jehu-Appiah C, Zere E. Using data envelopment analysis to measure the extent of technical efficiency of public health centres in Ghana. BMC international health and human rights, 2008; 8: 11.
12- Achoki T, Hovels A, Masiye F, Lesego A, Leufkens H, Kinfu Y. Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis. BMJ Open, 2017; 7(1): e012321.
13- Zhou L, Xu X, Antwi HA, Wang L. Towards an equitable healthcare in China: evaluating the productive efficiency of community health centers in Jiangsu Province. International Journal for Equity in Health, 2017; 16: 89.
14- Novignon J, Nonvignon J. Improving primary health care facility performance in Ghana: efficiency analysis and fiscal space implications. BMC Health Services Research, 2017; 17: 399.
15- yousefi nayyer m, Fazaeli AA, Hamidi Y. Assessment of the Efficiency of Hospitals Affiliated to Hamadan University of Medical Sciences Using Data Envelopment Analysis and Tobit Regression, Hamadan, Iran. Journal of Health Promotion Management, 2018; 7(4): 8-14.
16- Kiadaliri AA, Najafi B, Haghparast-Bidgoli H. Geographic distribution of need and access to health care in rural population: an ecological study in Iran. International journal for equity in health, 2011; 10(1): 1-7.
17- Mehraban R. An Appraisal on Efficiency of SSO’s Health Centers During the Years 2012-2014 Based on DEA Approach. majlis&rahbord, 2017;24(90): 74-101.
18- Mohebifar R GG, Rahimi H. technical efficiency in hospital of guilan university of medical sciences Guilan University of Medical Sciences, 2013; 22(88): 73-9.
19- Sahin I, Ozcan YA. Public sector hospital efficiency for provincial markets in Turkey. Journal of medical systems, 2000; 24(6): 307-20.
20- Ram Jat T, San Sebastian M. Technical efficiency of public district hospitals in Madhya Pradesh, India: a data envelopment analysis. Global health action, 2013; 6(1): 21742.
21- Safi-Arian R. Assessment of technical efficiency of hospitals under Hamadan University of Medical Sciences on performance indicators and data envelopment analysis model in 2010. Pajouhan Scientific Journal, 2013; 11(2): 27-34.
22- Mahfoozpour S, Pouragh B, Abedi Z, Satarivand S. Assessing efficiency in hospitals of Shahid Beheshti University of Medical
Sciences using Data Envelopement Analysis Method. Health Promotion Management, 2015; 5(1): 11-21.
23- Rostami Golmohammadi F, Kazemi Karyani A, Goudarzian M, Asefzadeh S, Mehraban S. Efficiency Determination of Rural Health Centers of Ghazvin Province Using Data Envelopment. Analysis Approach in 2006-2010 Period. Sabzevar University of Medical Sciences, 2016; 23(3): 444-56.
_||_1- Siciliani L. Estimating technical efficiency in the hospital sector with panel data. Applied Health Economics and Health Policy, 2006; 5(2): 99-116.
2- Hsiao B, Chen LH, Wu HT. Assessing performance of Taiwan hospitals using data envelopment analysis: In view of ownership. The International journal of health planning and management, 2019; 34(1): e602-e16.
3- MofarahZat A, Fazaeli AA, Hamidi Y. Study of socioeconomic factors affecting tuberculosis and its cost in Hamadan province. Hospital, 2020; 19(1): 9-16.
4- Emamrezaei A BM. Efficiency analysis of hospitals in Iran: A systematic review Payesh, 2016;16(1).
5- Shadpour K. Primary health care networks in the Islamic Republic of Iran. Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit, 2000; 6(4): 822-5.
6- Ahmad Kiadaliri A, Najafi B, Haghparast-Bidgoli H. Geographic distribution of need and access to health care in rural population: an ecological study in Iran. International Journal for Equity in Health, 2011; 10(1): 39.
7- Farahabadi m Ym, Bahmanziari n, Fazaeli s. Efficiency Analysis of Selected Urban Health Centers of Isfahan University of Medical Sciences. hospital, 2011; 10(1): 35-43.
8- Shoja n Aa, Khalili n. Performance Evaluation of Healthy Houses in Firouzkouh City Using Data Envelopment Analysis. economical modeling, 2014; 8(3): 53-69.
9- Azar A, Valipour khatir M, Moghbel baerz A, Hasas yeganeh Y. Evaluation of Hospital Efficiency by Data Envelopment Analysis: Tehran University of Medical Sciences: (2009-2011). Journal of Health Administration, 2013; 16(53): 36-46.
10- Zare Ahmadabadi H, Masoudian S, Zare Banadkouki MR. Evaluating the technical efficiency of Yazd City health centers with a combined approach of DEA and GT. The Journal of Shahid Sadoughi University of Medical Sciences, 2019; 26(8): 717-32.
11- Akazili J, Adjuik M, Jehu-Appiah C, Zere E. Using data envelopment analysis to measure the extent of technical efficiency of public health centres in Ghana. BMC international health and human rights, 2008; 8: 11.
12- Achoki T, Hovels A, Masiye F, Lesego A, Leufkens H, Kinfu Y. Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis. BMJ Open, 2017; 7(1): e012321.
13- Zhou L, Xu X, Antwi HA, Wang L. Towards an equitable healthcare in China: evaluating the productive efficiency of community health centers in Jiangsu Province. International Journal for Equity in Health, 2017; 16: 89.
14- Novignon J, Nonvignon J. Improving primary health care facility performance in Ghana: efficiency analysis and fiscal space implications. BMC Health Services Research, 2017; 17: 399.
15- yousefi nayyer m, Fazaeli AA, Hamidi Y. Assessment of the Efficiency of Hospitals Affiliated to Hamadan University of Medical Sciences Using Data Envelopment Analysis and Tobit Regression, Hamadan, Iran. Journal of Health Promotion Management, 2018; 7(4): 8-14.
16- Kiadaliri AA, Najafi B, Haghparast-Bidgoli H. Geographic distribution of need and access to health care in rural population: an ecological study in Iran. International journal for equity in health, 2011; 10(1): 1-7.
17- Mehraban R. An Appraisal on Efficiency of SSO’s Health Centers During the Years 2012-2014 Based on DEA Approach. majlis&rahbord, 2017;24(90): 74-101.
18- Mohebifar R GG, Rahimi H. technical efficiency in hospital of guilan university of medical sciences Guilan University of Medical Sciences, 2013; 22(88): 73-9.
19- Sahin I, Ozcan YA. Public sector hospital efficiency for provincial markets in Turkey. Journal of medical systems, 2000; 24(6): 307-20.
20- Ram Jat T, San Sebastian M. Technical efficiency of public district hospitals in Madhya Pradesh, India: a data envelopment analysis. Global health action, 2013; 6(1): 21742.
21- Safi-Arian R. Assessment of technical efficiency of hospitals under Hamadan University of Medical Sciences on performance indicators and data envelopment analysis model in 2010. Pajouhan Scientific Journal, 2013; 11(2): 27-34.
22- Mahfoozpour S, Pouragh B, Abedi Z, Satarivand S. Assessing efficiency in hospitals of Shahid Beheshti University of Medical
Sciences using Data Envelopement Analysis Method. Health Promotion Management, 2015; 5(1): 11-21.
23- Rostami Golmohammadi F, Kazemi Karyani A, Goudarzian M, Asefzadeh S, Mehraban S. Efficiency Determination of Rural Health Centers of Ghazvin Province Using Data Envelopment. Analysis Approach in 2006-2010 Period. Sabzevar University of Medical Sciences, 2016; 23(3): 444-56.