Evaluation of the health performances of the regions affiliated to the the ministry of health by multi-criteria decision making techniques

Abstract

Aim: The aim of this study is to determine the health performances of the regions in the 2019 Health Statistics Yearbook by using multi-criteria decision making techniques.
 Material and Method: The study is a cross-sectional study and the data used in the study were obtained from the Ministry of Health Statistics Yearbook 2019. The population of the study consists of 12 regions (Western Anatolia, Western Black Sea, Eastern Black Sea, Eastern Black Sea, Eastern Marmara, Aegean, Istanbul, Central Anatolia, Mediterranean, Northeastern Anatolia, Western Marmara, Southeastern Anatolia, and Central Anatolia) included in the 2019 Health Statistics Yearbook. No sample was selected, and all regions were included in the study. ENTROPY Method was used for weighting the criteria and TOPSIS Method was used for ranking the alternatives. A total of 11 criteria, including six benefit criteria (number of general practitioners per 100,000 people, number of specialists per 100,000 people, number of hospital beds per 10,000 people, number of nurses and midwives per 100,000 people, number of hemodialysis devices per million people, and number of MRI devices per million people) and 5 cost criteria (infant mortality rate, maternal mortality rate, population per family medicine unit, crude mortality rate, population per 112 emergency aid station) were evaluated. Analyses were performed in Microsoft Excel program.
 Results: In the study, the three most effective criteria used to determine the health performances of the regions were respectively determined as maternal mortality rate (28.68%), population per 112 emergency aid stations (17.43%), and crude death rate (15.63%). As a result of the analyzes of the TOPSIS Method, the five regions with the best health performance among the regions are Western Anatolia (0.68), Western Black Sea (0.66), Eastern Black Sea (0.65), Eastern Marmara (0.63), and Aegean (0.56) has been identified. While the average performance score of the regions is found as 0.53, Istanbul (0.51), Middle East Anatolia (0.50), Mediterranean (0.49), Northeast Anatolia (0.46), West Marmara (0.44), Southeastern Anatolia (0.40), and Central Anatolia (0.33) regions remained below this average.
 Conclusion: The most important criteria in evaluating the health performances of regions are; maternal mortality rate, population per 112 emergency aid stations, and crude death rate. The regions with the best health performance are Western Anatolia, Western Black Sea and Eastern Black Sea. In order to improve the health performance of the regions, maternal mortality rate, crude death rate and population per family physician should be reduced.