تعيين كارآيي واحدهاي بهداشتي مراكز بهداشت شهرستان هاي استان گلستان در سال هاي 80-1378

Efficiency of district health centers in Golestan province during 1999-2001

Introduction: Efficiency is one of the most important criteria for resource allocation in all organizations. Measurement of efficiency needs almost complex mathematical and statistical procedures with advanced expertise. The main objectives of this study were establishment of a new and practical method. for estimating efficiency in district level and to apply it in Golestan province health centers during 1999-2001. Methods: In order to measure deprivation, input and output four, eight and thirteen indicators were selected, respectively. Data were gathered from routine data sources of district health network including DTARH software, census and statistical forms. Main factors of deprivation, input and output were determined by principle component analysis. Each factor was weighted, based on variances in the model, to build combined indicators, for deprivation, input and output, separately. Linear regression analysis was used to determine expected output far a given deprivation and input. Efficiency of each district in any interval could be determined based of absolute difference on observed and expected outputs. Results: Though principle component analysis one indicator was selected for deprivation, three for input and three for output. Gonbad and Minodasht districts had the maximum (2.69) and minimum (-2.84) efficiencies among all Golestan province districts, respectively. Gonbad had the highest efficiency during 1999 and 2000 with 0.06 and 7.04 scores. Agh-ghala illustrated the highest efficiency in 2001 with 0.46 score. Minodasht showed the lowest scores during all of three years with -7.02, -0.87 and 0.41 scores. Conclusion: Trend of efficiency illustrates less variation in 2001 in comparison with 1999. This difference could he explained by appropriate allocation of resources and management that have been performed in recent years. Further studies are necessary to improve model validity for determination of efficiency. These studies could be, fulfilled with more districts data and with a wider range of indicators.