Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Sağlıkta Verimlilik Karne Uygulamaları, Hastanelerin Etkinliğinin Retrospektif Olarak Stokastik Sınır Yaklaşımı ile Değerlendirilmesi: AI Rol Grubu Hastaneler Örneği
Health Efficiency Scorecard Applications, Retrospective Evaluation of Hospitals Efficiency with Stochastic Boundary Approach: The Case of AI Role Group Hospitals
Mehmet KOCAa, Yeter DEMİR USLUa
aİstanbul Medipol Üniversitesi Sağlık Bilimleri Fakültesi, Sağlık Yönetimi ABD, İstanbul, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2022;7(1):212-20
doi: 10.5336/healthsci.2021-81180
Article Language: TR
Full Text
ÖZET
 Amaç: Sağlık Bakanlığı (SB) AI rol grubu hastanelerin etkinliğinin belirlenmesi ve hastanelerin etkinliğinin verimlilik karne uygulamaları başlangıcından itibaren nasıl değiştiğini belirlemek amacı ile yapılmıştır. Gereç ve Yöntemler: Stokastik Sınır Analizi (SSA), karar verme birimlerinin etkinliklerini ölçek için kullanılan parametrik bir yöntem olup; etkinsizliğin rassal hatadan mı yoksa etkinsizlikten mi kaynaklandığını ayırt edebilmesi nedeniyle son yıllarda yapılan çalışmalarda daha fazla kullanılmaya başlanmıştır. Bu nedenle, SB'ye bağlı 48 AI rol grubunda bulunan genel hastanelerin 2012 ve 2018 yılları arasındaki (7 yıllık panel veri) verileri belirlenen girdi ve çıktıları SSA yöntemi kullanılarak hesaplanmıştır. Bulgular: Çalışmada, öncelikle SSA modeli klasik regresyon modeline karşı test edilmiş ve daha sonra SSA yönteminde uygun modelin belirlenmesi için Battese ve Coelli (1992) modeline getirilen ƞ=0 kısıtının ve µ=0 kısıtının geçerliliği test edilmiştir. Test sonucunda ƞ parametresi 0,0086 (p=0,307) ve µ parametresi 0,2885 (p=0,156) olarak bulunmuştur. Her 2 parametrede %5 seviyesinde pozitif ve anlamsız bulunmuştur. Yapılan testler sonucunda klasik SSA modelleri arasında, Translog Üretim Fonksiyonu formunda oluşturulan Battese ve Coelli (1995) modelinin, eldeki veri setine en uygun model olduğu tespit edilmiştir. Analiz sonucunda hastanelerin etkinliği Model 1'de 0,25-0,93 arasında; Model 2'de 0,76-0,97 arasında olduğu tespit edilmiştir. Sonuç: Üretim sınırından sapmalar incelendiğinde, Model 1'de yaklaşık %29, Model 2'de %17'lik kısmın teknik etkinsizlikten (𝑢𝑖) kaynaklandığından bu alanda düzenleme yapılarak hastanelerin etkinliğinin artırılabileceği sonucuna ulaşılmıştır.

Anahtar Kelimeler: AI rol grubu hastaneler; hastanelerin etkinliği; stokastik sınır analizi
ABSTRACT
 Objective: The purpose of determining the efficiency of the AI role group hospitals of the Ministry of Health and determining how the efficiency of the hospitals have changed since the beginning of the efficiency report card applications was made. Material and Methods: Stochastic Frontier Analysis (SFA) is a parametric method used to scale the effectiveness of decision-making units; Due to the fact that it can distinguish whether ineffectiveness is caused by random error or inefficiency, it has been used more in recent years. For this reason, the inputs and outputs of the general hospitals in 48 AI role groups affiliated to the Ministry of Health between 2012 and 2018 (7-year panel data) were calculated using the SFA method. Results: In the study, the SFA model was first tested against the classical regression model and then the validity of the ƞ=0 constraint and the µ=0 constraint introduced to the Battese and Coelli (1992) model in order to determine the appropriate model in the SFA method. As a result of the test, the ƞ parameter was found to be 0.0086 (p=0.307) and the µ parameter as 0.2885 (p=0.156). Both parameters were found to be positive and insignificant at the 5% level. As a result of the tests, it was determined that Battese and Coelli (1995) model created in the form of Translog Generation Function among classical SFA models is the most suitable model for the data set. As a result of the analysis, the efficiency of hospitals is between 0.25 and 0.93 in Model 1; it has been found to be between 0.76 and 0.97 in Model 2. Conclusion: When the deviations from the production limit are examined, it is concluded that the efficiency of hospitals can be increased by making arrangements in this area, since approximately 29% in Model 1 and 17% in Model 2 are caused by technical inefficiency (𝑢𝑖).

Keywords: AI role group hospitals; efficiency of hospitals; stochastic frontier analysis
REFERENCES:
  1. Emiral F. Türk Bankacılık sistemindeki etkinlik analizi (veri zarflama analizi uygulaması) [Yüksek lisans tezi]. İstanbul: Marmara Üniversitesi Bankacılık ve Sigortacılık Enstitüsü; 2001. Erişim Tarihi: 10.10.2020. [Link] 
  2. Güran MC, Tosun U. Türkiye ekonomisinin makroekonomik performansı: 1951-2003 dönemi için parametrik olmayan bir ölçüm [The macroeconomic performance of Turkey's economy: A non-parametric measurement for 1951-2003 period]. Ankara Üniversitesi SBF Dergisi. 2005;60(4):89-115. [Link] 
  3. İnan EA. Banka etkinliğinin ölçülmesi ve düşük enflasyon sürecinde bankacılıkta etkinlik. Bankacılar Dergisi. 2000;34:82-96. [Link] 
  4. Akal Z. İşletmelerde Performans Ölçüm ve Denetimi: Çok Yönlü Performans Göstergeleri. 7. Baskı. Ankara: Milli Prodüktivite Merkezi Yayınları; 2011. [Link] 
  5. Alacahan Y. Sağlık hizmetlerinde kurumsal karne (balanced scorecard) uygulaması ve kamu hastanelerinin kapasitesi üzerine etkileri [Yüksek lisans tezi]. İstanbul: Nişantaşı Üniversitesi; 2016. Erişim Tarihi: 10.02.2020. [Link] 
  6. Çakmak EH, Dudu H, Öcal N. Türk Tarım sektöründe etkinlik: yöntem ve hanehalkı düzeyinde nicel analiz. Ankara: TEPAV Yayınları; 2008. p.34-52. [Link] 
  7. Greene WH. The econometric approach to efficiency analysis. The Measurement of Productive Efficiency and Productivity Growth. 2008;92-250. [Crossref] 
  8. Aigner D, Lovell CAK, Schmidt P. Formulation and estimation of stochastic frontier production function models. Journal of Econometrics. 1977;6(1):21-37. [Crossref] 
  9. Battese G, Coelli T. Frontier production functions, technical efficiency and panel data: with application to paddy farmers in ındia. The Journal of Productivity Analysis. 1992;3(1-2):153-69. [Crossref] 
  10. Kodde DA, Palm FC. Wald Criteria for Jointly Testing Equality and Inequality Restrictions. Econometrica. 1986;54:1243-8. [Crossref] 
  11. Atılgan E. Hastane etkinliğinin stokastik sınır analizi yöntemiyle değerlendirilmesi: T.C. Sağlık Bakanlığı hastaneleri için bir uygulama [Doktora tezi]. Ankara: Hacettepe Üniversitesi Sosyal Bilimler Enstitüsü; 2012. p.30-63. Erişim Tarihi: 15.02.2020. [Link] 
  12. Hamidi S. Measuring efficiency of governmental hospitals in Palestine using stochastic frontier analysis. Cost Effectiveness and Resource Allocation. 2016;14(1):1-12. [Crossref]  [PubMed]  [PMC] 
  13. Kiprono JJ. How efficient are Kenyan hospitals?: an application of frontier analysis techniques [Doktora tezi]. Milton Keynes: The Open University; 2016. Erişim Tarihi: 10.10.2020. [Link] 
  14. Kawaguchi H, Hashimoto H, Matsuda S. Efficacy of a numerical value of a fixed-effect estimator in stochastic frontier analysis as an indicator of hospital production structure. BMC Health Services Research. 2012;12(1):21-7. [Crossref]  [PubMed]  [PMC] 
  15. Keskin Hİ. Sağlıkta dönüşüm programı altında, Türkiye'deki Sağlık Kurumlarının Etkinliğinin Değerlendirilmesi [Doktora tezi]. Ankara: Gazi Üniversitesi Sosyal Bilimler En­stitüsü; 2017. Erişim Tarihi: 15.02.2020. [Link] 
  16. Ataş Ö. Bayesyen stokastik sınır analizi ile kamu hastanelerinde etkinlik analizi [Yüksek lisans tezi]. Manisa: Celal Bayar Üniversitesi Sosyal Bilimler Enstitüsü; 2019. Erişim Tarihi: 15.02.2020
  17. Antwi BD. Estimating the cost and technical Efficiency of Norwegian hospitals: An application of stochastic frontier analysis [Yüksek lisans tezi]. Oslo: University of Oslo; 2017. Erişim Tarihi: 10.10.2020 [Link] 

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