Türkiye’de Aile Sağlığı Merkezlerinin Teknik Etkinlik Düzeylerinin İncelenmesi

Abstract

Performance evaluation in health sector is crucial in terms of the elements that needs to be done better, namely, the success of the healthcare institutions, stand and survive the competition, meet the health expectations and needs of the citizens and development of the process and results of the business operations. As the family medicine system is newly adopted in Turkey and the limited number of performance evaluation studies provide motivational impact on taking this study into consideration. In this study, family health centers (FHC) were evaluated through efficiency, a dimension of the performance evaluation; it was aimed to determine the efficiency scores of the FHC, detect the use of inputs that lead FHC to be effienct or inefficient and identify the potential areas of improvement for the inefficient FHC to be efficient. For this purpose, activities were evaluated with two approaches. In the first approach, in 2015, 6902 ASM throughout Turkey were taken as decision making units and analyzed as groups determined by the Ministry of Health. In this approach, four inputs and eight outputs were used as variables. In the second approach, financial inputs were added to first approach and with the help of the variables of nine inputs and eight outputs, efficiency performances of 81 provinces were evaluated in terms of family practice services. Data envelopment analysis developed by Charnes, Cooper and Rhodes (CCR) was used as method. In both approaches, input-oriented models were constructed. According to findings, the average efficiency values of the FHC groups were between 53.00% and 71.80% and it was found that efficiency scores show a statistically significant difference according to groups. Also, as the number of units in the groups increased, the average efficiency score decreased. The numbers of the variables of the registered people of family practice services, family practice units and family practitioners were found to be the major variables in the FHC-level analysis of efficient and inefficient units. In the province based analysis, the average efficiency score of the provinces was determined as 91.66% and that 31 provinces were efficient and the other 50 were inefficient. In the last part of the study, suggestions about the areas that need to be focused on were listed for the FHC and provinces to improve their efficiencies.