Turkiye Klinikleri Journal of Health Sciences

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Kaynak Tabanlı Performans Değerlendirme: Entropi Tabanlı OCRA Yöntemiyle Sağlık Hizmetlerine Yönelik Tanımlayıcı Bir Araştırma
Resource Based Performance Assessment: A Descriptive Research on Health Services with Entropy Based OCRA Method
Gizem Zevde AYDINa, Ferdane Betül BÖLÜKBAŞIb
aOndokuz Mayıs Üniversitesi Sağlık Bilimleri Fakültesi, Sağlık Yönetimi Bölümü, Samsun, Türkiye
bHacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi, Sağlık Yönetimi Bölümü, Ankara, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(4):1187-208
doi: 10.5336/healthsci.2022-91758
Article Language: TR
Full Text
ÖZET
 Amaç: Araştırmanın amacı, Türkiye'deki illerin 5 yıllık periyotta sağlık hizmetleri altyapısı ve sağlıkta insan kaynağı açısından değerlendirilmesidir. Gereç ve Yöntemler: Araştırma kapsamında çok kriterli karar verme yöntemlerinden Entropi ve Operasyonel Rekabet Değerlendirmesi [Operational Competitiveness Rating (OCRA)] bütünleşik olarak kullanılmıştır. Analiz kapsamında 81 il alternatif olarak ele alınmıştır. Yapılan literatür araştırması sonucunda, illerin sağlık hizmetleri altyapısı ve sağlıkta insan kaynağı açısından değerlendirilmesi için belirleyici olduğu görülen 11 sağlık göstergesi değerlendirme kriteri olarak belirlenmiştir. Çalışmada kullanılan 2015-2019 yıllarına ait verilerin tamamına Sağlık Bakanlığı Sağlık İstatistikleri Yıllıklarından erişilmiştir. Verilerin analizinde Microsoft Excel programı kullanılmıştır. Bulgular: Entropi yöntemi bulguları analizin gerçekleştirildiği tüm yıllarda en önemli kriterin 112 ambulans başına düşen nüfus olduğunu göstermektedir. OCRA yöntemi sonucunda; analizin gerçekleştirildiği tüm yıllarda Tunceli ilk sırada; İstanbul ise son sırada yer almıştır. Bolu ve Isparta tüm yıllarda üst sıralarda yer alan diğer illerdir. Bulgular literatürde farklı yöntemler kullanılarak gerçekleştirilen araştırmaların bulguları ile paralellik göstermektedir. Sonuç: Araştırmanın sonucunda, nüfus yoğunluğu fazla olan büyükşehirlerin sağlıkta altyapı ve insan kaynağı bakımından en alt sıralarda yer aldığı görülmüştür. Bu illerde sağlık hizmeti kullanıcıları sayısının fazlalığı, sağlık altyapısı ve insan kaynağı yetersizliğine neden olabilmektedir. İllerin nüfuslarına ve ihtiyaçlarına göre insan kaynakları ve sağlık altyapısının daha dengeli olarak yeniden dağılımını sağlayacak politikalar üzerine çalışılmasının faydalı olacağı düşünülmektedir.

Anahtar Kelimeler: Sağlık hizmetleri; sağlık hizmetleri dağılımı; karar verme; Entropi; OCRA
ABSTRACT
 Objective: The aim of the research is to evaluate the provinces in Türkiye in terms of health services infrastructure and human resources over a 5-year period. Material and Methods: Entropy and Operational Competitiveness Rating (OCRA), which are the multi-criteria decision-making methods, were used in an integrated manner within the scope of the research. Within the analysis, 81 provinces were considered as alternatives. According to the literature, 11 health indicators, which are seen to be decisive for the evaluation of provinces in terms of health services infrastructure and human resources, have been determined as evaluation criteria. The data for the years 2015-2019 used in the study can be accessed from Health Statistics Annuals of the Ministry of Health. In the analysis of the data, Microsoft Excel was used. Results: The entropy method findings show that the most important criterion in all years of performing analysis is the population per 112 ambulances. As a result of the OCRA; Tunceli ranked first in all the years; İstanbul, on the other hand, took the last place. Bolu and Isparta are the other provinces that rank high in all years. The findings are parallel with the literature. Conclusion: According to the results, metropolitans with a high population are in the lowest ranks in terms of infrastructure and human resources. The high number of users in these provinces may cause inadequacy of health infrastructure and human resources. It is thought that it will be beneficial to work on policies that will ensure a more balanced redistribution of human resources and infrastructure according to the populations and needs of the provinces.

Keywords: Health services; health care rationing; decision making; Entropy; OCRA
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