Bir Ilin Aile Hekimlerinin Veri Zarflama Analizi ile Performanslarını Değerlendirme Çalışması

Abstract

Primary health care services are the gate to health system as well as being the core of the whole system. Effective supply of primary health services reduces the burden of diseases and enables secondary and tertiary level health institutions to provide a better and more qualified health care and education. This study aimed to evaluate the performance levels of family physicians in some specific areas, to determine the efficient and inefficient areas in their services, to analyze the relationship between their incomes related activities and their performance and to evaluate their performance according to the demographical distribution of the registered population. The study group of this cross sectional study includes 56 family physicians who had been actively working in Sinop between 2008 and 2009. Analyses were made using the data collected by Sinop Province Health Directory. Data Envelopment Analysis was used for performance assessment according to the objectives of the study as this technique evaluates the efficiency, provides a holistic approach for the evaluation of multiple inputs and outputs by total factor efficiency and states the difference between the current and targeted values. The areas that family physicians are efficient or inefficient have been identified as a result of the study. The average technical efficiency score and standard deviation of the family physicians according to the results of the output oriented variable returns to scale data envelopment analysis are 0.99±0.04. The technical efficiency scores of the family physicians vary between 0.785 and 1.00; and there are 45 (83,33%) family physicians that have complete technical efficiency score. 9 family physicians are identified to be inefficient. The relation between their performance and their income related services and the demographical distribution of their registered population are not statistically significant. The assessment needs to be repeated with new variables periodically. The assessments of the family physicians should be done according to the criteria that Ministry of Health determines and data should be collected accurately, systematically and on time. In addition to the quantitative analysis with the assessment of data; service quality should also be added to the assessment to also enable qualitative analysis.