رتبه‌بندی استان‌های ایران از نظر وجود منابع بهداشتی و درمانی و سطح دسترسی افراد به آنان با استفاده از تصمیم‌گیری چند شاخصه
محورهای موضوعی : -مدارک پزشکیعباس جهانگیری 1 , محمد جهانگیری 2 , علی مصلی 3
1 - باشگاه پژوهشگران جوان و نخبگان، واحد خمین، دانشگاه آزاد اسلامی، خمین، ایران
2 - کارشناس‌ارشد مهندسی بهداشت حرفه ای، سازمان تامین اجتماعی، مدیریت درمان استان مرکزی، درمانگاه تخصصی شماره 3 اراک، اراک، ایران
3 - کارشناس متخصص بهداشت حرفه ای، سازمان تامین اجتماعی، ستاد مرکزی، اداره کل درمان مستقیم، تهران، ایران.
کلید واژه: تصمیم‌گیری چند شاخصه, توسعه یافتگی, دسترسی, منابع بهداشتی و درمانی,
چکیده مقاله :
مقدمه: توسعه‌یافتگی بخش بهداشت و درمان یک جامعه بر اساس وجود منابع مختلف بهداشتی و درمانی و سطح دسترسی افراد به آنان سنجیده می‌شود. هدف از پژوهش حاضر رتبه‌بندی استان‌های ایران از نظر وجود منابع بهداشتی و درمانی و سطح دسترسی افراد به آنان با استفاده از تصمیم‌گیری چند شاخصه بود. روش پژوهش: در این مطالعه موردی و مقطعی که داده‌های مورد نیاز با مراجعه به سامانه سالنامه آماری به دست آمده است، نمرات توسعه یافتگی 30 استان ایران با استفاده یکی از جدیدترین روش‌های تصمیم‌گیری چند شاخصه به نام "ارزیابی محصول جمع شده با وزن" با در نظرگیری 24 شاخص مهم بهداشتی و درمانی به کمک نرم‌افزار Excel 2010 مورد ارزیابی قرار گرفت. یافته‌ها: از نظر وجود منابع بهداشتی و درمانی، استان تهران با اختلاف بسیار زیادی نسبت به سایر استان‌های کشور و با کسب نمره 0.9131 رتبه نخست و استان سمنان با کسب نمره 0.0603 رتبه آخر را به دست آورده‌اند در حالی که از نظر دسترسی افراد به آن منابع و توجه به جمعیت هر استان، استان ایلام با کسب نمره 0.1146 رتبه نخست و استان خوزستان با کسب نمره 0.0409 رتبه آخر را به دست آورده‌اند. نتیجه‌گیری: استان‌های ایران از نظر وجود منابع بهداشتی و درمانی و هم‌چنین سطح دسترسی افراد به آنان با یکدیگر اختلاف دارند و منابع بخش سلامت به طور یکسان توزیع نشده است.
Introduction: The development of healthcare sector in a society is measured by existence of healthcare resources and level of people's access to them. The purpose of this paper was ranking provinces of Iran in terms of existence of healthcare resources and level of people's access to them by using Multiple Attribute Decision Making (MADM). Methods: In this sectional case study that data requirement has earned by referring to statistical yearbook system, development scores of 30 Provinces of Iran by using one of newest MADM methods named Weighted Aggregated Sum Product Assessment (WASPAS) with considering 24 important healthcare indicators were evaluated via Excel 2010 software. Results: In terms of existence of healthcare resources, the province of Tehran with a great difference compared to other provinces of the country with a score of 0.9131 and the province of Semnan with a score of 0.0603 have earned the first and last rank respectively while in terms of level of people's access to them with attention to the population of each province, Ilam with a score of 0.1146 and Khuzestan with a score of 0.0409 have earned the first and last rank respectively. Conclusion: Provinces of Iran in terms of existence of healthcare resources and level of people's access to them are different from each other and healthcare sector resources are not distributed equally.
1- Sadeghifar J, Seyedin H, Anjomshoa M, Vasokolaei GR, Mousavi SM, Armoun B. Degree of the Development of Bushehr Province Towns in Health Indicators Using Numerical Taxonomy. Razi Journal of Medical Sciences, 2014; 21(118): 81-91. [in persian]
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5- Bahrami R. Analysis of the health sector development in the cities of Kurdistan using linear topsis. Scientific- Research Quarterly of Geographical Data (SEPEHR), 2016; 24(96): 39-49. [in persian]
6- Kazemi A, Rezapoor A, Bagheri faradonbeh S, Nakhaei M, Ghazanfari S. Study the Development level of Provinces in Iran: A Focus on Health Indicators. Journal of Health Administration, 2015; 18(59): 29-42. [in persian]
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11- Theodorakis PN, Mantzavinis GD. Inequalities in the distribution of rural primary care physicians in two remote neighboring prefectures of Greece and Albania. Rural and remote health, 2005; 5(3): 457-465.
12- Jahangiri A, Jahangiri M. Performance Evaluation of Hospital by Using Dynamic Multiple Attribute Decision Making (DMADM): A Case Study in Imam Khomeini Hospital Affiliated to Social Security Organization in Arak. Journal of healthcare management, 2017 05/22; 8(1): 91-102. [Article n persian]
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14- Zavadskas EK, Turskis Z, Antucheviciene J, Zakarevicius A. Optimization of Weighted Aggregated Sum Product Assessment. Electronics and Electrical Engineering, 2012; 122(6): 3-6.
15- Vafaeipour M, Hashemkhani Zolfani S, Morshed Varzandeh MH, Derakhti A, Keshavarz Eshkalag M. Assessment of regions priority for implementation of solar projects in Iran: New application of a hybrid multi-criteria decision making approach. Energy Conversion and Management, 2014; 86: 653-63.
16- Zavadskas EK, Kalibatas D, Kalibatiene D. A multi-attribute assessment using WASPAS for choosing an optimal indoor environment. Archives of Civil and Mechanical Engineering, 2016; 16(1): 76-85.
17- Statistical Center of Iran. Statistical Yearbook System 2015 [cited 2017 2017/08/02]. Available from: https://nnt.sci.org.ir/sites/apps/yearbook/year_book_doc/94-99-18.pdf. [Web site in persian].
18- statistical Center of Iran. The general results of the general census of population and housing 2016 2016 [cited 2017 2017/08/02]. Available from: https://www.amar.org.ir/Portals/0/census/1395/results/tables/jamiat/kolli/1-koli-jamiat.xls.[Web site in persian].
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1- Sadeghifar J, Seyedin H, Anjomshoa M, Vasokolaei GR, Mousavi SM, Armoun B. Degree of the Development of Bushehr Province Towns in Health Indicators Using Numerical Taxonomy. Razi Journal of Medical Sciences, 2014; 21(118): 81-91. [in persian]
2- Elyaspour B, Elyaspour D, Hejazi A. A study of the degree of development in the health sector of towns in North Khorasan province using numerical taxonomy in 2006. Journal of North Khorasan University of Medical Sciences, 2011; 3(1): 23-8. [in persian]
3- Ghazanfarpour H. Stratification & development ratio of medical Service in Kerman Province cities by concentration index. Spatial Planning, 2014; 3(4): 1-18. [in persian]
4- Jafari M, Seyfi H, Jafari A. Measuring the Health & Treatment Sector Development Level in Zanjan Province Townships by Numerical Taxonomy Method in 2011 .Journal of Healthcare Management, 2013; 4(1,2): 61-9. [in persian]
5- Bahrami R. Analysis of the health sector development in the cities of Kurdistan using linear topsis. Scientific- Research Quarterly of Geographical Data (SEPEHR), 2016; 24(96): 39-49. [in persian]
6- Kazemi A, Rezapoor A, Bagheri faradonbeh S, Nakhaei M, Ghazanfari S. Study the Development level of Provinces in Iran: A Focus on Health Indicators. Journal of Health Administration, 2015; 18(59): 29-42. [in persian]
7- Rezaei S, Kazemi K, Ghahremani E. Development status and access to health care resources using numerical taxonomy and Morris Model: A case study. Scientific Journal of Kurdistan University of Medical Sciences, 2015; 20(2): 40-50. [in persian]
8- Mousavi M, Meshkini A, Veysian M, Hosseini M. Assess the Levels of development Health services With the model Multiple Criteria Decision Making (Case study: city of Khorasan Razavi province). Journal of Studies of Human Settlements Planning(JSHSP), 2017; 11(37): 99-112. [in persian]
9- Sun S, Chen J, Johannesson M, Kind P, Xu L, Zhang Y, et al. Regional differences in health status in China: population health-related quality of life results from the National Health Services Survey 2008. Health & place, 2011; 17(2): 671-80.
10- Zheng X, Song X, Chen G, You Y, Ren Q, Liu J, et al. Health inequalities during 20 years of rapid economic development in China (1980-2000): a mortality analysis. Biomedical and environmental sciences : BES, 2011; 24(4): 329-34.
11- Theodorakis PN, Mantzavinis GD. Inequalities in the distribution of rural primary care physicians in two remote neighboring prefectures of Greece and Albania. Rural and remote health, 2005; 5(3): 457-465.
12- Jahangiri A, Jahangiri M. Performance Evaluation of Hospital by Using Dynamic Multiple Attribute Decision Making (DMADM): A Case Study in Imam Khomeini Hospital Affiliated to Social Security Organization in Arak. Journal of healthcare management, 2017 05/22; 8(1): 91-102. [Article n persian]
13- Asgarpour MJ. Multiple Criteria Decision Making. 9th Edition. Tehran: University of Tehran; 2011: 399.[in persian]
14- Zavadskas EK, Turskis Z, Antucheviciene J, Zakarevicius A. Optimization of Weighted Aggregated Sum Product Assessment. Electronics and Electrical Engineering, 2012; 122(6): 3-6.
15- Vafaeipour M, Hashemkhani Zolfani S, Morshed Varzandeh MH, Derakhti A, Keshavarz Eshkalag M. Assessment of regions priority for implementation of solar projects in Iran: New application of a hybrid multi-criteria decision making approach. Energy Conversion and Management, 2014; 86: 653-63.
16- Zavadskas EK, Kalibatas D, Kalibatiene D. A multi-attribute assessment using WASPAS for choosing an optimal indoor environment. Archives of Civil and Mechanical Engineering, 2016; 16(1): 76-85.
17- Statistical Center of Iran. Statistical Yearbook System 2015 [cited 2017 2017/08/02]. Available from: https://nnt.sci.org.ir/sites/apps/yearbook/year_book_doc/94-99-18.pdf. [Web site in persian].
18- statistical Center of Iran. The general results of the general census of population and housing 2016 2016 [cited 2017 2017/08/02]. Available from: https://www.amar.org.ir/Portals/0/census/1395/results/tables/jamiat/kolli/1-koli-jamiat.xls.[Web site in persian].
