ارزیابی و تحلیل توزیع فضایی شاخص‌های خدمات بهداشت و درمان با تأکید بر عدالت اجتماعی، مطالعه موردی: شهرستان‌های استان خراسان جنوبی

نوع مقاله : علمی-پژوهشی

نویسندگان

1 استادیار، گروه جغرافیا و برنامه‌ریزی شهری، دانشگاه سیستان و بلوچستان، زاهدان، ایران.

2 کارشناسی ارشد، گروه جغرافیا و برنامه‌ریزی شهری، دانشگاه سیستان و بلوچستان، زاهدان، ایران.

3 دانشجوی دکتری، گروه جغرافیا و برنامه‌ریزی شهری، دانشگاه سیستان و بلوچستان، زاهدان، ایران.

چکیده

خدمات بهداشت و درمان یکی از ارکان توسعه محسوب می شود و توزیع عادلانه آن‌ یکی از پیش‌نیازهای اصلی بهبود سطح برخورداری جامعه از سلامت و خدمات بهداشتی و درمانی می‌باشد. پژوهش حاضر با بهره‌گیری از روش تحلیل عاملی و تکنیک چند شاخصه آراس و با استفاده از 41 شاخص بهداشت و درمان به سطح‌بندی شهرستان‌های استان خراسان جنوبی می‌پردازد. رویکرد حاکم بر این پژوهش توصیفی – تحلیلی و از نوع کاربردی- توسعه‌ای است و برای تهیه نقشه سطح‌بندی از نرم‌افزار GIS استفاده‌شده است. با استفاده از مدل تحلیل عاملی تأییدی شاخص‌های خدمات بهداشت و درمان از تعداد 90 شاخص اولیه به تعداد 41 شاخص کاهش و در چهار دسته تقسیم‌بندی شدند؛ سپس با استفاده از مدل آراس هریک از شهرستان‌های استان خراسان جنوبی ازلحاظ برخورداری از شاخص‌های بهداشت و درمان رتبه‌‌بندی شدند، نتایج حاصل از مدل آراس نشان می‌دهد که شاخص‌های خدمات بهداشت و درمان از پراکندگی زیادی برخوردار است و اختلاف زیادی بین شهرستان‌های خراسان جنوبی ازلحاظ برخورداری از شاخص‌های خدمات بهداشت و درمان وجود دارد و شهرستان فردوس به‌عنوان برخوردارترین و شهرستان خوسف به‌عنوان محروم‌ترین شهرستان استان می‌باشند؛ همچنین با استفاده از ضریب پراکندگی (cv)، میزان توزیع و پراکندگی هر یک از شاخص‌های بهداشت و درمان بررسی شد و نتایج حاصل از آن بیانگر توزیع نابرابر هر یک از شاخص‌های بهداشتی در سطح شهرستان‌های استان خراسان جنوبی می‌باشد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Assessing and Analyzing the Spatial Distribution of Indicators of Health Services with Emphasis on Social Justice, Case study: Cities of South Khorasan Province

نویسندگان [English]

  • Hamid Reza Rakhshaninasab 1
  • Khadije Azari tabas 2
  • Mojtaba Soleimani Dameneh 3
1 Assistant Professor, Department of Geography and Urban Planning, University of Sistan and Baluchestan, Zahedan, Iran.
2 Msc, Department of Geography and Urban Planning, University of Sistan and Baluchestan, Zahedan, Iran.
3 Ph.D Student, Department of Geography and Urban Planning, University of Sistan and Baluchestan- Zahedan, Iran.
چکیده [English]

Health services are one of the pillars of development and Its fair distribution is one of the main prerequisites for improving the level of the society's enjoyment of health and healthcare services.The present study uses the factor analysis factor and multi-indicator Aras technique and uses 41 health indicators to level the cities of South Khorasan province. The approach to this research is descriptive-analytical and applied-developmental, and GIS software is used to prepare the leveling map. Using the confirmatory factor analysis model, the indicators of health services decreased from 90 to 41 and were divided into four categories; then, using the Aras model, each of the cities of South Khorasan province in terms of having indicators. Healthcare ranked, results from the Aras model show that healthcare indicators are very scattered and there is a big difference between the cities of South Khorasan in terms of having healthcare service indicators. And Ferdows city as the most privileged city of Khosf as the most deprived city of the province Also, using the scattering coefficient (cv), The extent and distribution of each of the health indicators was investigated and the results indicate the unequal distribution of each health indicator in the cities of South Khorasan province.

کلیدواژه‌ها [English]

  • Health Services
  • Health and Treatment Indicators
  • Social Justice
  • Development
  • South Khorasan Province
Ahadnejad Rrvshti, M., Gholamhosseini, R., & Zulfi, A. (2011). Evaluation of the cities of Mazandaran province in terms of access to health and treatment infrastructures using TOPSIS and MORIS model. Chashmandaz-EZAGROS 3(8), 53-68. (In Persian)
Ahmadi, S., Saburikhah, H., Darvishi, H., & Jabari, H. (2014). Spatial analysis of the health index of Iran's provinces, Regional Planning Quarterly, 4(14), 31-44. https://sid.ir/paper/230761/en
Alvani, M., Rudgarnejad, F., & Kia Kojouri, K. (2012). Development Management, Safar Publications, second edition, Tehran. (In Persian)
Babanaseb, R., Abbasi, S., Kohzadi, E., & Rakhshani Moghadam, H. (2015). Leveling and analysis of indicators of development of health and treatment services in Khuzestan province using factor and cluster analysis, The first International Congress of Earth, Space and Clean Energy, Mohagheg Ardabili University, Ardabil. (In Persian)
Bagheri, N., Benwell, G. L., & Holt, A. (2005). Measuring spatial accessibility to primary health care, Presented at the 17th Annual Colloquium of the Spatial Information Research Centre (SIRC) A Spatio-temporal Worksho, 103–108.
Bahrami, R. (2015). An Analysis on the Extent of Health Sector Developmentin the Cities of Kurdistan Province Using Linear TOPSIS Method. Journal of Geographical Data (SEPEHR), 24(96), 39-49. (In Persian) https://doi.org/10.22131/sepehr.2016.18942
Burton, E. (2001). The Compact City and Social Justice, a Paper Presented to Housing Studies Association, Spring Conference, Housing, Environmental and Sustainability, University of York.
Elyaspour, B., Elyaspour, D., & Hejazi, A. (2011). A Study of the Degree of Development in the Health Sector of Towns in North Khorasan Using Numerical taxonomy in the Year 2006. Journal of North Khorasan University of Medical Sciences, 3(1), 23-28. (In Persian)
Emamgholipour Sefiddashti, S., & Shirani Faradonbeh, R. (2017). Distribution of Facilities and Accessibility to Health Services in Kerman Province in 2013. Health and Development Journal, 6(2), 123-132. (In Persian)
Ghanzanfarpour, H., Musazadeh, H., & Khodadad, M. (2020). Assessment and Developmental Leveling of Hamedan Cities Based on the Indicators of Health & Treatment Using Fuzzy TOPSIS (FTOPSIS) and Arc GIS. Quarterly Journal of Geography Environment Preparation, 13(51), 201-179. (In Persian) 20.1001.1.2676783.1399.13.51.9.4
Ghazanfarpour, H., Kakadzfouli, A., & Kakadzfouli, A. (2018). Evaluation and analysis of spatial development indices of health services in Fars province using a combination of several indicators (TOPSIS, VIKOR, SAW). Geography(Regional Planning) Journal, 7(26), 20, 110-91. (In Persian) 20.1001.1.22286462.1396.7.2.6.8
Gulliford, M., & Morgan, M. )2003(. Access to health care: Routledge. London: New Fetler LAN.
Hadder, R. (2003). Development Geography, Routledge. London. New York.
Hafez Nia, M. R., Ahmadipour, Z., & Qadri Hajat, M. (2012). Politics and Space, Papli Publications: Mashhad. (In Persian)
Hekmatnia, H., Givehchi, S., Heydari Nowshehr, N., & Heydari Nowshehr, M. (2011). Analysis Distribution of Urban Public Services with Data Standardization, Taxonomy and Specification Coefficient Model (Case Study: Ardakan Town). Human Geography Research, 43(3), 179-165. (In Persian)
Jafari, F., Shamaei, A., & Hatami, A. (2018). An analysis spatial inequality based on health and care indicator (Case Study: Counties of Tehran province). Geography (Regional Planning) Journal, 9(1), 17-27. (In Persian) Dor: 20.1001.1.22286462.1397.9.1.2.2
Jin, M., Liu, L., Tong, D., Gong,‌ Y., & Yu, L. (2019). Evaluating the Spatial Accessibility and Distribution Balance of Multi-Level Medical Service Facilities,‌ Int J Environ Res Public Health, 16(7), 1150. https://doi.org/10.3390/ijerph16071150
Karimi, I., Salarian, A., & Anbari, Z. (2010). A comparative study on equity in access to health services in developed countries and designing a model for Iran. Journal of Arak University Medical Sciences, 12(4), 92-104. (In Persian)
Karimzadeh, M., & Karimzadeh, B. (2018). Evaluating Development level of Sistan and Baluchistan Province in Terms of Accessibility to Health Care Services. Zanko Journal of Medical Sciences, 19(62), 18-30. (In Persian)
Kiyani, A., Fazel Nia, Gh., & Jamshidi, P. (2013). The Assessment of Health Centers Services of Zabol City Using TOPSIS Model. The Journal of Geography and Planning (JGP), 17(43), 190-169. (In Persian)
Kuntalp, M., & Orkun, A. (2004). A simple and lowcost Internet-based teleconsultation system that could effective elysolve the healthcare access problems in underserved areas of developing countries Mehmet, Computer Methods and Programs in Biomedicine, 75(2), 117-26. DOI: 10.1016/j.cmpb.2003.11.004
McLaughlin, C., & Wyszewianski, L. (2002). Access to care: remembering old lessons. Health Serv Re , 37(6), 1441. DOI: 10.1111/1475-6773.12171
Mir, S. A., Khosravi, S., Mansoori Bidkani, M., Khosravi, A. A. (2019). Expanding the health care in deprived areas in Iran:policies and challenges. Journal of Military Medicine, 21(4), 352 -342. (In Persian)
Mohammadi, J., Ahmadian, M., Ali-zadeh, J., & Gemini, D. (2012). Spatial Analysis of Health and Sanitary Indicators of Western Azerbaijan. Social Welfare Quarterly12(47), 153-180. (In Persian)
Mullen, M.T., Wiebe, D.J., Bowman, A., Wolff, C.S., Albright, K.C., & Roy, J. (2014). Disparities in accessibility of certified primary stroke centers. Stroke. 45(11), 3381-3388. https://doi.org/10.1161/STROKEAHA.114.006021
Najarzadeh, Mo., Torabi, Z., Shokriani, M., & Hosni Jalilian, P. (2020). Study of Spatial Justice in Health-Counseling Indicators In the cities of Golestan province. Strategic Studies of public Policy, 10(36), 281-260. (In Persian)
Nazmfar, H., & Naderpour, M. (2009). Analysis of regional inequalities using numerical taxonomy and cluster analysis techniques, Second Conference of Geographical Sciences, Payam Noor University, West Azarbaijan Province. (In Persian)
Oladipo, J. A. (2014). Utilization of health care services in rural and urban areas: a determinant factor in planning and managing health care delivery systems. African Health Sciences, 14(2), 322-333. DOI: 10.1016/j.healthplace.2013.05.003
Pallikadavath, S., Singh, A., Ogollah, R., Dean, T., & Stones, W.(2013). Human resource inequalities at the base of India's public health care system. Health & place. 23, 26-32. DOI: 10.1016/j.healthplace.2013.05.003
Salehpour, Sh., & Afrokhte, H. (2016). On the Analysis of Health Services Development Level from the Spatial Equity Point of View (Case Study: Rural Settlements of West Azerbaijan Province). Journal of Studies of Human Settlements Planning, Human Settlements Planning Quarterly, 36(11), 19-38. (In Persian)
Statistics of South Khorasan Province. (2016). (In Persian)
Sun, S., Jiaying, Ch., Magnus, J., Paul, K., Ling, X., Yaoguang, ZH., & Kristina, B. (2011). Regional differences in health status in China: Population health-related quality of life results from the National Health Services, Survey 2008. Health & Place, 17(2), 671. DOI: 10.1016/j.healthplace.2011.01.007
Taghdisi, A., Piri, S., & Behari, I. (2013). Spatial Analyzing and Ranking Indexes of Medical Care Services Development Using Factor and Cluster Analysis (Case Study: Townships of Gilan Province). Quarterly Journal of Geography Environment Preparation, 5(18), 145. (In Persian)
Witter, S., Ann Sour, T., Jewett, M., & Robin, T. (2004). Health Economics for Developing Countries, Higher Institute of Planning Management Education and Research, Tehran. (In Persian)
Yazdani, M. H., Ramadan, H., & Mostafapour, M. (2017). Analysis of Health Indicators Status in Districts of Ardabil Province. Journal of Health, 7(5), 687-697. (In Persian)
Zangiabadi, A., Amirazdi, T., & Prizadi, T. (2012). Spatial analysis of indicators of development of health and treatment services in Kurdistan province. Iranian Geographical Association, 10(32). 215-199. (In Persian)
Zangiabadi, A., Behari, I., Qadri, R. (2014). Spatial Analysis and Ranking of the Health Indicators Using GIS, Geographical Research, 28(1), 75-106. (In Persian)
Zarrabi, A., Mohammadi, J., & Rakhshani Nasab, H. (2008). Spatial Analysis of Health and Medical Services Development Indices. Social Welfare Quarterly, 7(27), 213-234. (In Persian)
Zere, E., Mandlhate, C., Mbeeli, T., Shangul, K., Mutirua, K., & Kapenambili, W. (2007). Equity in health care in Namibia: developing a needs-based resource allocation formula using principal components analysis. International Journal for Equity in Health, 6(1), 1-7. DOI: 10.1186/1475-9276-6-3
Zheng, XY., Song, XM., Chen, G., You, YZ., Ren, Q., Liu, J., Zhang, L., Tan, LF., Wei, J., & Chen, QY. (2011). Health Inequalities during 20 Years of Rapid Economic Development in China (1980-2000), A Mortality Analysis. Biomed Environ Sci. 24 (4), 329. DOI: 10.3967/0895-3988.2011.04.002
Ziyari, K., Safai Reineh, M., &Arvin, M. (2016). Evaluation of Spatial Distribution of Health-Treatment Services and Presentation of Optimal Distribution Model, Case Study: Khuzestan Province, Geography and Territorial Spatial Arrangement (GTSA), 6(19), 90-71. (In Persian)20.1001.1.23452277.1395.6.19.9.3