ارزیابی سطوح توسعه یافتگی خدمات بهداشتی-درمانی با مدل تصمیم گیری چند معیاره (مطالعه موردی : شهرستانهای استان خراسان رضوی)
محورهای موضوعی : مطالعات برنامه ریزی شهری و منطقه ای
میر نجف موسوی
1
,
ابوالفضل مشکینی
2
,
محمد ویسیان
3
,
معصومه حسینی
4
1 - دانشیار جغرافیا و برنامه‌ریزی شهری، دانشگاه ارومیه، ارومیه، ایران
2 - استادیار جغرافیا و برنامه‌ریزی شهری، دانشگاه تربیت مدرس، تهران، ایران
3 - دانش آموخته کارشناسی ارشد جغرافیا و برنامه‌ریزی شهری، دانشگاه خوارزمی، تهران، ایران
4 - دانش آموخته کارشناسی ارشد جغرافیا و برنامه‌ریزی شهری، دانشگاه حکیم سبزواری، سبزوار، ایران
کلید واژه: توسعه یافتگی, شاخص‌های بهداشتی-درمانی, استان خراسان رضویی, مدل تصمیم گیری چند معیاره,
چکیده مقاله :
خدمات بهداشتی-درمانی در سطح شهرستانها با سلامت بهداشت و روان شهروندان ارتباط مستقیم دارد. بهبود وضعیت خدمات بهداشتی-درمانی شهروندان یکی از نشانه‌های ارتقاء و توسعه انسانی است. ارزیابی سطوح توسعه یافتگی با استفاده از روش‌های کمی از سوی منجر به شناخت میزان نابرابری بین مناطق می‌گردد و از سوی دیگر تلاشی در زمینه کاهش و رفع نابرابری‌های موجود می‌باشد. پژوهش حاضر با هدف بهره‌گیری از شاخص‌های مدنظر، به دنبال سنجش وضع توزیع و توسعة خدمات بهداشتی -درمانی در شهرستانهای این استان و مشخص کردن میزان اختلاف توسعه در بین آنها و نیز متوجه ساختن مسئولان به توجه بیشتر به شهرستانهای محروم و توسعه نیافته است. روش تحقیق، توصیفی– تحلیلی و نوع تحقیق کاربردی است داده‌های تحقیق شامل 15شاخص خدمات بهداشتی-درمانی از آخرین سرشماری(1390) اخذ گردید. در این پژوهش با استفاده از مدل Topsis و Vikor به الویت‌بندی شهرستانهای استان خراسان رضوی بر اساس شاخص‌های توسعه خدمات-بهداشتی در چهار سطح (فرابرخوردار، برخوردار، نیمه برخوردار، فروبرخوردا) پرداخته شده است. نتایج تحقیق بیانگر این است که شهرستان مشهد به عنوان مرکز اداری سیاسی و اقتصادی استان، برخوردارترین شهرستان از لحاظ شاخص‌های توسعه یافتگی خدمات بهداشتی-درمانی بوده و اختلاف چشمگیری با سایر شهرستانهای استان دارد. در سطح دوم توسعه یافتگی شهرستانهای نیشابور و سبزوار قرار دارند و بقیه شهرستانها در سطح نیمه برخوردار و فروبرخوردار جای دارند. یافته‌های پژوهش حاکی از این است که محرومیت کلی در سطح کل استان از نظر برخورداری از شاخص‌های خدمات بهداشتی-درمانی حاکم است و توزیع خدمات بهداشتی-درمانی موجود نیز چندان متناسب با نیازهای جمعیتی شهرستانها انجام نشده است.
Health services In city surface with health and health mental of the citizens of Relationship Direct are. Improve Condition the health of citizens is a sign of the promotion of and human development. Assess the Levels of development Using quantitative methods Led to the identification of The inequality Between the areas And the Other effort In Fields Reduction And fixes Inequalities. The present study With the aim of Exploitation The parameters considered, Looking Assessment of Situation distribution And development Health Services The city of the province, Determine the Differences in development Between them And Also Realized the Officials More attention city of Underserved and underdeveloped. Methodology, descriptive analytic And applied research The data consists of 15 indicators of health services from the last census (1390) was received. In this studyusing the model Topsis and Vikor To prioritize city of Khorasan Razavi Based on indicators of health care-The four levels Discussed . Results of the study suggest that Mashhad city as the administrative center of political and economic In situation developed City In terms of indicators Health services are Significant difference with other County There. Cities Nishapur and Sabzevar located on the second level of development And Other Cities In Level Partially Deprived And Deprived Located. Research findings suggests that Deprivation Kelly In the Provincial In terms of Entitlement Indicators of health services Dominates And distribution Health services Available Proportional With the needs Population cities Not carried out.
Amanpur, S., Alizadeh, H., & Damanbagh, S. (2014). Evaluate the Development Of The Cities Of Kermanshah from the Perspective of Allocating Utilities Indices. Environmental Based Territorial Planning (Amayesh), 6 (23),105-126. (In Persian)
Farajisabokbar, H.A., & Vazin, N. (2013). Structural model of relationship between health services and health indicators. Social Welfare Journal, 13 (48), 28-46. (In Persian)
Farnoodi, S. (2010). Presenting a framework for evaluation of health technology in health and medical system of Iran; case study: robolens robot. Journal of Sciences and Technology Policy, 2 (3), 75-86. (In Persian)
Fleurbaeya, M., & Schokkaert, E. (2009). Unfair inequalities in health and health care. Journal of Health Economics,28, 73-90.
Ghazanfarpour, H. (2014). Stratification & development ratio of medical services in kerman province cities by concentration index. Journal of Spatial Planning, 3 (4), 1-17. (In Persian)
Hung-yi, W., & Gwo-hshiung, T., & Yi-hsuan, C. )2009(. A fuzzy mcdm approach for evaluating banking performance based on balanced scorecard. Expert systems with applications Journal, 36, 10135-10147.
Jih-jeng, H., & Gwo-hshiung, T., & Hsiang-his, L. )2009(. A revised vikor model for multiple criteria decision making-the perspective of regret theory. The smithsonian/nasa astrophysics data system, 35, 761- 768.
Karimi, I., Salarian, A., & Anbari, Z. (2010). A comparative study on equity in access to health services in developed countries and designing a model for Iran. Arak Medical University Journal, 12 (4), 92-104. (In Persian)
Lotfi, S., & Shabani, M. (2013). Presenting an integrated model for ranking regional development a case study of health and of medical services Mazandran province. Journal of geography Sciences, 13 (28), 7-30. (In Persian)
Makdissia, P., & Yazbeck, M. (2014). Measuring socioeconomic health inequalities in presence of multiplecategorical information. Journal of Health Economics, 34, 84-95.
McGrail, M.R., & Humphreys, J.S. (2009). Measuring spatial accessibility to primary care in rural areas: Improving the effectiveness of the two-step floating catchment area method. Applied Geography, 29, 533-541.
Mindella, J.S., & Forde, A. (2008). A review of health impact assessment Frameworks. Public Health,112 (11), 1177-1187.
Mohammadi, J., Ahmadian, M., Alizadeh, J., & Jamini, D. (2013). Spatial analysis of health and sanitary indicators of western Azerbaijan. Social Welfare Journal, 12 (47), 153-180. (In Persian)
Momeni, M., & Saber, E. (2012). Determining the developmental level of Nain city in Esfahan province. Geography Environmental planning, 23 (1), 185-200.
Peters, D.J. (2013). American income inequality across economic and geographic. Social Science Research, 42, 1490-1504.
Rezvani, M. R. (2005). Measure and analyze the levels of development of rural areas in the city of Sanandaj. Journal of geography and regional development, 3,164-149. (In Persian)
Rydin, Y., & Bleahu, A., & Davies, M. (2012). Shaping cities for health: complexity and the planning of urban environments in the 21st century. The Lancet Commissions, 379 (2), 2079-2108.
Saraei, M. H., & Kamaiezade, Y. (2013). Determining the Development Ratio of Counties of the Province of Yazd in Terms of Accessing Treatment and Hygiene Centers Using Mourice Model. Environmental Based Territorial Planning (Amayesh), 6 (22), 63-80. (In Persian)
Sarvar, R., Mousavi, M. N., & Yazdani, R. (2013). The Analysis of Spatial Distribution and Positioning Medical Care by Multi Criterion Multi Phase Decision Making Model: a Case Study: City Miandoaab. Journal Environmental Based Territorial Planning (Amayesh), 22 (6), 81-100. (In Persian)
Sepehrdoust, H. (2011). Factors affecting the development From the Viewpoint of Health Indicators. Journal Health Inform Action Management, 8 (2), 1-8. (In Persian)
Statistical Yearbook, Razavi Khorasan Province. (2012). (In Persian)
Taghvaei, M., & Shahivandi, A. (2011). Spatial distribution of health services in Iranian cities. Social Welfare Journal, 10 (39), 33-54. (In Persian)
Taghvaei, M., & Shahivandi, A. (2011). Spatial distribution of health services in Iranian cities. Social Welfare Journal, 10 (39), 33-54. (In Persian)
Taghvaei, M., & Saboori, M. (2012). Determining and analysis the development levels and degree of townships in Hormozgan province. Geography Environmental Planning, 23(2), 53-68. (In Persian)
Taghvaei, M., Varesi, H. R., & Shaykgbayglo, R. (2012). Analysis of regional development inequalities in Iran. Human Geography Research Quarterly, 43 (78), 153-168. (In Persian)
Zangi Abadi, A., Ahmadian, M., Shahsevani M. J., & Aliazdeh, J. (2014). Spatial Analysis of Regional Development in province of Bushehr using by Mcdm Models. Quarterly Of Regional Planning, 3 (12), 1-10. (In Persian)
Zangi Abadi, A., Bahari, I., & Ghaderi, R. (2013). Spatial Analysis and Ranking of the Health Indicators Using GIS. Geography Research, 28 (108), 75-106. (In Persian)
Zangi Abadi, A., Amirazodi, T., & Parizadi, T. (2012). Spatial analysis of health and medical services development indices. Journal Geography, 10 (32), 199-215. (In Persian)
Zarrabi, A., Mohamadi, J., & Rakhshaninasab, H. (2008). Spatial analysis of health and medical services development indices. Social Welfare Journal, 7 (27), 213-234. (In Persian)
Zayyari, K., Zanjirchi, S. M., & Sorkhkamal, K. (2010). A Study and Measurement of the Development Degree of the Counties of Razavy Khorasan Province Using TOPSIS Technique. Human Geography Research Quarterly, 42 (2), 17-30. (In Persian)
_||_Amanpur, S., Alizadeh, H., & Damanbagh, S. (2014). Evaluate the Development Of The Cities Of Kermanshah from the Perspective of Allocating Utilities Indices. Environmental Based Territorial Planning (Amayesh), 6 (23),105-126. (In Persian)
Farajisabokbar, H.A., & Vazin, N. (2013). Structural model of relationship between health services and health indicators. Social Welfare Journal, 13 (48), 28-46. (In Persian)
Farnoodi, S. (2010). Presenting a framework for evaluation of health technology in health and medical system of Iran; case study: robolens robot. Journal of Sciences and Technology Policy, 2 (3), 75-86. (In Persian)
Fleurbaeya, M., & Schokkaert, E. (2009). Unfair inequalities in health and health care. Journal of Health Economics,28, 73-90.
Ghazanfarpour, H. (2014). Stratification & development ratio of medical services in kerman province cities by concentration index. Journal of Spatial Planning, 3 (4), 1-17. (In Persian)
Hung-yi, W., & Gwo-hshiung, T., & Yi-hsuan, C. )2009(. A fuzzy mcdm approach for evaluating banking performance based on balanced scorecard. Expert systems with applications Journal, 36, 10135-10147.
Jih-jeng, H., & Gwo-hshiung, T., & Hsiang-his, L. )2009(. A revised vikor model for multiple criteria decision making-the perspective of regret theory. The smithsonian/nasa astrophysics data system, 35, 761- 768.
Karimi, I., Salarian, A., & Anbari, Z. (2010). A comparative study on equity in access to health services in developed countries and designing a model for Iran. Arak Medical University Journal, 12 (4), 92-104. (In Persian)
Lotfi, S., & Shabani, M. (2013). Presenting an integrated model for ranking regional development a case study of health and of medical services Mazandran province. Journal of geography Sciences, 13 (28), 7-30. (In Persian)
Makdissia, P., & Yazbeck, M. (2014). Measuring socioeconomic health inequalities in presence of multiplecategorical information. Journal of Health Economics, 34, 84-95.
McGrail, M.R., & Humphreys, J.S. (2009). Measuring spatial accessibility to primary care in rural areas: Improving the effectiveness of the two-step floating catchment area method. Applied Geography, 29, 533-541.
Mindella, J.S., & Forde, A. (2008). A review of health impact assessment Frameworks. Public Health,112 (11), 1177-1187.
Mohammadi, J., Ahmadian, M., Alizadeh, J., & Jamini, D. (2013). Spatial analysis of health and sanitary indicators of western Azerbaijan. Social Welfare Journal, 12 (47), 153-180. (In Persian)
Momeni, M., & Saber, E. (2012). Determining the developmental level of Nain city in Esfahan province. Geography Environmental planning, 23 (1), 185-200.
Peters, D.J. (2013). American income inequality across economic and geographic. Social Science Research, 42, 1490-1504.
Rezvani, M. R. (2005). Measure and analyze the levels of development of rural areas in the city of Sanandaj. Journal of geography and regional development, 3,164-149. (In Persian)
Rydin, Y., & Bleahu, A., & Davies, M. (2012). Shaping cities for health: complexity and the planning of urban environments in the 21st century. The Lancet Commissions, 379 (2), 2079-2108.
Saraei, M. H., & Kamaiezade, Y. (2013). Determining the Development Ratio of Counties of the Province of Yazd in Terms of Accessing Treatment and Hygiene Centers Using Mourice Model. Environmental Based Territorial Planning (Amayesh), 6 (22), 63-80. (In Persian)
Sarvar, R., Mousavi, M. N., & Yazdani, R. (2013). The Analysis of Spatial Distribution and Positioning Medical Care by Multi Criterion Multi Phase Decision Making Model: a Case Study: City Miandoaab. Journal Environmental Based Territorial Planning (Amayesh), 22 (6), 81-100. (In Persian)
Sepehrdoust, H. (2011). Factors affecting the development From the Viewpoint of Health Indicators. Journal Health Inform Action Management, 8 (2), 1-8. (In Persian)
Statistical Yearbook, Razavi Khorasan Province. (2012). (In Persian)
Taghvaei, M., & Shahivandi, A. (2011). Spatial distribution of health services in Iranian cities. Social Welfare Journal, 10 (39), 33-54. (In Persian)
Taghvaei, M., & Shahivandi, A. (2011). Spatial distribution of health services in Iranian cities. Social Welfare Journal, 10 (39), 33-54. (In Persian)
Taghvaei, M., & Saboori, M. (2012). Determining and analysis the development levels and degree of townships in Hormozgan province. Geography Environmental Planning, 23(2), 53-68. (In Persian)
Taghvaei, M., Varesi, H. R., & Shaykgbayglo, R. (2012). Analysis of regional development inequalities in Iran. Human Geography Research Quarterly, 43 (78), 153-168. (In Persian)
Zangi Abadi, A., Ahmadian, M., Shahsevani M. J., & Aliazdeh, J. (2014). Spatial Analysis of Regional Development in province of Bushehr using by Mcdm Models. Quarterly Of Regional Planning, 3 (12), 1-10. (In Persian)
Zangi Abadi, A., Bahari, I., & Ghaderi, R. (2013). Spatial Analysis and Ranking of the Health Indicators Using GIS. Geography Research, 28 (108), 75-106. (In Persian)
Zangi Abadi, A., Amirazodi, T., & Parizadi, T. (2012). Spatial analysis of health and medical services development indices. Journal Geography, 10 (32), 199-215. (In Persian)
Zarrabi, A., Mohamadi, J., & Rakhshaninasab, H. (2008). Spatial analysis of health and medical services development indices. Social Welfare Journal, 7 (27), 213-234. (In Persian)
Zayyari, K., Zanjirchi, S. M., & Sorkhkamal, K. (2010). A Study and Measurement of the Development Degree of the Counties of Razavy Khorasan Province Using TOPSIS Technique. Human Geography Research Quarterly, 42 (2), 17-30. (In Persian)