Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach

KAÇAK, Hakan

doi:10.5505/TurkHijyen.2023.34793

Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach

Hakan KAÇAK (Ankara Üniversitesi, Akreditasyon, Akademik Değerlendirme ve Kalite Koordinatörü, Ankara, Türkiye)

Türk Hijyen ve Deneysel Biyoloji Dergisi

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Yıl: 2023 Cilt: 80 Sayı: 3 Sayfa Aralığı: 329 - 344 Metin Dili: İngilizce DOI: 10.5505/TurkHijyen.2023.34793 İndeks Tarihi: 28-09-2023

Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach

Öz:

Objective: Monitoring and comparing regional service performance is inevitable to use resources effectively and allocate resources without creating interregional inequalities. With the Health Transformation Program, there has been an increase in the amount and quality of the service provided throughout the country. In addition, there has been a decrease in the inequalities between regions due to its implementation. In order to ensure continuity in health service delivery, health service activities in provinces and regions should be followed regularly, and their performance should be evaluated. Methods: The study calculated Data Envelopment Analysis efficiencies and Cross-efficiency for 26 subregions in the NUTS-II classification in Turkey. The number of hospital beds and primary care units were the inputs of the research; the number of primary, secondary and tertiary care visits and the number of inpatients are also the output of the study. Subregions are reordered and grouped according to their cross-efficiency. Decision-making units with unusual production structures were investigated by calculating Maverick Index scores. Results: Regarding DEA efficiency, the average efficiency score of the ten subregions classified as efficient is 0.97 (sd. 0.0395). The average cross-efficiency score obtained from the benevolent method is 0.89 (sd. 0.058), while the average score achieved through the aggressive method is 0.86 (sd. 0.574). Maverick index scores had a balanced distribution. The average maverick index score for aggressive and benevolent are 0.13 (std. 0.0474), and 0.0871 (std. 0.0420), respectively. Although only the Malatya subregion was classified as efficient in the traditional DEA method, it had low scores in the cross-efficiency evaluation and was classified as a maverick decision unit with an MI score of 0.21. Conclusion: The cross-efficiency method yields more valuable results because it employs more realistic weights for peer evaluation. These outcomes are simpler for decision-makers to comprehend and assess. The regions of Kocaeli, Adana, Aydın, Hatay, Şanlıurfa, and Tekirdağ exhibit notable performance in the cross-efficiency examination, as they have attained the most significant efficiency scores. The regions of Kastamonu, Erzurum, Van, and Ağrı exhibit poor levels of efficiency, thereby requiring the implementation of precautionary measures.

Anahtar Kelime: Cross-efficiency data envelopment analysis health policy performance management

Çapraz etkinlik yaklaşımı ile Türkiye’deki bölgesel sağlık hizmetleri performansının değerlendirilmesi

Öz:

Amaç: Kaynakların etkin kullanılması ve kaynak tahsisinin bölgeler arası eşitsizlikler yaratmaksızın yapılabilmesi için bölgesel hizmet performansının izlenmesi ve karşılaştırılması kaçınılmazdır. Sağlıkta Dönüşüm Programı ile ülke genlinde sunulan hizmetin miktar ve kalitesinde artışlar olmuştur. Ayrıca hizmet sunumundan kaynaklı bölgeler arası eşitsizliklerde de azalmalar olmuştur. Sağlık hizmetlerinde sürekliliğin sağlanması için illerde ve bölgelerdeki sağlık hizmetlerinin düzenli bir şekilde takip edilmesi ve performanslarının değerlendirilmesi gerekmektedir. Yöntem: Çalışmada Türkiye’deki IBBS-II sınıflamasında yer alan 26 alt bölgenin Veri Zarflama Analizi etkinlikleri ile Çapraz Etkinlikleri hesaplanmıştır. Hastane yatağı ve birinci basamak sağlık hizmet birimi sayıları araştırmanın girdilerini; birinci, ikinci ve üçüncü basamak sağlık tesislerindeki hasta muayene sayıları ile yatan hasta sayıları da çalışmanın çıktılarını oluşturmaktadır. Alt bölgeler çapraz etkinliklerine göre yeniden sıralanmış ve gruplandırılmıştır. Tüm alt bölgeler için Maverick İndeks puanları hesaplanarak sıra dışı üretim yapılarına sahip olan alt bölgeler belirlenmiştir. Bulgular: Veri zarflama analizi etkinlikleri bakımından on alt bölge etkin olarak gruplandırılmış olup bölgelerin ortalama etkinlik skoru 0,97’dir (sd. 0,0395 ). Benevolent yaklaşıma göre hesaplanan çapraz etkinlik ortalama skoru 0,89 (sd. 0,058) iken aggresive yaklaşıma göre hesaplanan ortalama skor ise 0,86’dır (sd. 0,0574). Maverick indeks skorları dengeli olarak dağılmıştır. Ortalama agressive maverick indeks skoru 0,13 (std. 0.0474) ve ortalama benevolent Maverick indeks skoru ise 0,0871’dir (std. 0.0420). Sadece Malatya alt bölgesi, geleneksel veri zarflama analizi yönteminde etkin olarak sınıflandırılmasına rağmen çapraz etkinlik değerlendirmesinde düşük skorlar almış ve 0,21 indeks skoru ile maverick karar birimi olarak sınıflandırılmıştır. Sonuç: Çapraz etkinlik yöntemi daha gerçekçi ağırlıklar kullanarak akran-değerlendirmesi yaptığı için daha kullanışlı sonuçlar ortaya koymaktadır. Söz konusu sonuçların karar alıcılar tarafından anlaşılması ve değerlendirilmesi daha kolaydır. Çapraz etkinlik değerlendirmesinde Kocaeli, Adana, Aydın, Hatay, Şanlıurfa ve Tekirdağ alt bölgeleri en yüksek etkinlik skorlu bölgeler olarak öne çıkmaktadır. Kastamonu, Erzurum, Van ve Ağrı alt bölgeleri de düşük etkinlik skorlu bölgeler olup önlem alınması gerekmektedir.

Anahtar Kelime: Çapraz etkinlik veri zarflama analizi sağlık politikası performans yönetimi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	KAÇAK H (2023). Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach. , 329 - 344. 10.5505/TurkHijyen.2023.34793
Chicago	KAÇAK Hakan Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach. (2023): 329 - 344. 10.5505/TurkHijyen.2023.34793
MLA	KAÇAK Hakan Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach. , 2023, ss.329 - 344. 10.5505/TurkHijyen.2023.34793
AMA	KAÇAK H Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach. . 2023; 329 - 344. 10.5505/TurkHijyen.2023.34793
Vancouver	KAÇAK H Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach. . 2023; 329 - 344. 10.5505/TurkHijyen.2023.34793
IEEE	KAÇAK H "Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach." , ss.329 - 344, 2023. 10.5505/TurkHijyen.2023.34793
ISNAD	KAÇAK, Hakan. "Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach". (2023), 329-344. https://doi.org/10.5505/TurkHijyen.2023.34793

APA	KAÇAK H (2023). Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach. Türk Hijyen ve Deneysel Biyoloji Dergisi, 80(3), 329 - 344. 10.5505/TurkHijyen.2023.34793
Chicago	KAÇAK Hakan Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach. Türk Hijyen ve Deneysel Biyoloji Dergisi 80, no.3 (2023): 329 - 344. 10.5505/TurkHijyen.2023.34793
MLA	KAÇAK Hakan Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach. Türk Hijyen ve Deneysel Biyoloji Dergisi, vol.80, no.3, 2023, ss.329 - 344. 10.5505/TurkHijyen.2023.34793
AMA	KAÇAK H Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach. Türk Hijyen ve Deneysel Biyoloji Dergisi. 2023; 80(3): 329 - 344. 10.5505/TurkHijyen.2023.34793
Vancouver	KAÇAK H Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach. Türk Hijyen ve Deneysel Biyoloji Dergisi. 2023; 80(3): 329 - 344. 10.5505/TurkHijyen.2023.34793
IEEE	KAÇAK H "Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach." Türk Hijyen ve Deneysel Biyoloji Dergisi, 80, ss.329 - 344, 2023. 10.5505/TurkHijyen.2023.34793
ISNAD	KAÇAK, Hakan. "Regional performance evaluation of healthcare services in Türkiye with cross-efficiency approach". Türk Hijyen ve Deneysel Biyoloji Dergisi 80/3 (2023), 329-344. https://doi.org/10.5505/TurkHijyen.2023.34793