Distribution of Facilities and Accessibility to Health Services in Kerman Province in 2013

Authors

Abstract

Background: Equitable distribution of healthcare resources is one of the main factors in improving the community's health level. The aim of this study was to determine the degree of development in the cities of Kerman province with a focus on health indicators.


Methods: This was a descriptive cross-sectional study. The study population was all 23 cities of Kerman province in 2013. All indicators of accessibility to health care were obtained from the Statistical Centre of Iran (SCI). Taxonomy techniques were used to determine the degree of development in the cities, Shannon entropy techniques were used to determine the weights of indicators, and TOPSIS techniques were used to rank cities. Data was analysed by EXCEL.


Results: According to taxonomy techniques, based on accessibility to health services among 23 cities, 9 were developed, 7 were semi-developed, and 7 were underdeveloped. According to Shannon entropy, the ratio of the number of pharmacists to the population of cities was the main indicator for determining the weight of development in the cities. According to TOPSIS, Ravar was ranked as the first and Arzoiyeh as the last one in terms of development.


Conclusion: There is inequitable distribution of resources, especially human resources with higher education. This is probabily due to the tendency of highly educated individuals to live in developed cities with high facilities. In addition, due to lack of proper medical facilities in disadvantaged areas, higher educated human resources refuse to live in such areas. Therefore, policy makers should allocate budjet and make political decisions based on development priorities.

Keywords


1. Rabiee M, Heidari S, Shariat-Bahadori M, Kani S. Effect of health indicators on economic development: review of developed and developing countries. Economic Journal. 2013;13(7-8):73-88. Persian 2. Asefzadeh S. Basic of Economic of Health Care 1th ed. Tehran: Frouzesh; 2011. Persian 3. Seidaee SE, Jamini D, Jamshidi A. Analysing heslth care indicators of Kermanshah province cities using TOPSIS, AHP and cluster analysis. Spatial Planing (Geography). 2013;4(1):46-64. Persian 4. Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, et al. Human resources for health: overcoming the crisis. Lancet. 2004 Nov 27-Dec 3;364(9449):1984-90. 5. Culyer AJ. The dictionary of health economics: 2th ed. Cheltenham, UK: Edward Elgar Publishing; 2010. 6. Nasiripour AA, Maleki MR, Tabibi SJ, Ehsani Chimeh E. Factors influence on geographic distribution of physicians in selected countries: a review article. J Kermanshah Univ Med Sci. 2013;17(9):600-10. Persian 7. Emamgolipor Sefiddashti S, Ghazanfari S. Ranking Islamic republic of Iran’s development vision countries in term of access to healthcare indicators. Journal of Health Administration. 2014;18(58):58-71. Persian 8. Shahabi M, Tofighi S, Maleki M. The nurse and specialist physicians' manpower distribution by population and its relationship with the number of beds at public hospitals in Iran’s 2001-2006. Journal of Health Administration. 2010;13(41):7-14. Persian 9. Taheri Mehrjardi MH, Babae Meybodi H, Morovati Sharifabadi A. investigation and ranking of Iranian provinces in terms of access to health sector indicators. Health Information Management. 2012;9(3):356-69. Persian 10. Sheykh Beygloo R, Taghvaeei M, Varesi H. The spatial analysis of deprivation and inequalities of development in sub-provinces of Iran. Social Welfare. 2012; 12 (46):215-45. Persian 11. Sayeh Miri A, Sayeh Miri K. Health and treatment ranking in Ilam towns using principeal components method and numrical taxonomy technique. Journal of Ilam University of Medical Sciences. 2001:8-9(29-30):30-5. Persian 12. Elyaspour B, Elyaspour D, Hejazi A. A study of the degree of development in the health sector of towns in North Khorasan province using numerical taxonomy in 2006. Journal of North Khorasan University of Medical Sciences. 2011; 3(1):23-8. Persian 13. Rezaei S, Ghazanfari S, Kazemi Z, Kazemi Karyani A. Access to healthcare facilities: case study of Kermanshah province. J Kermanshah Univ Med Sci. 2014; 18(7): 416-25. Persian 14. Rezaei S, Barouni M, Ghazanfari S, Kazemi Karyani A, Hidarnejad N, Mohammadi B. Disparities in access to health care: case of Iran. Health Med. 2014;8(11):1262-74. 15. Asadei R. Evaluating and determining the degree of Development in the cities and towns of Kerman Province. Population Quarterly. 2006; 71-72:89-101. Persian 16. Anjomshoa M, Mousavi SM, Seyedin H, Ariankhesal A, Sadeghifar J, Shaarbafchi-Zadeh N. Evidence for policy making: health services access and regional disparities in Kerman. Iran J Health Sci. 2013; 1(3):35-42. 17. Statistical Centre of Iran. Iran Statistical Yearbook: Healthcare; 2013 [cited 2013 May 29]. Available from: https://nnt.sci.org.ir/sites/apps/yearbook/year_book_doc/92-99-17.pdf. 18. Ghazanfarpoor H. Stratification & development ratio of medical Service in Kerman Province cities by concentration index. Journal of Spatial Planning. 2013;3(4):1-18. Persian 19. Taghvaei M, Mosayebi S. Classification of the benefit of Kerman city using Mauritius model and GIS technique. Journal of Geography and Urban Planning. 2012;4(12):111-32. Persian 20. Enghoff H. What is taxonomy? – An overview with myriapodological examples. Soil Organisms. 2009;81(3):441-51. 21. Mokhtarian M. A note on Extension of fuzzy TOPSIS method based on interval-valued fuzzy sets. Applied Soft Computing. 2015;26:513-4. 22. Nemati R, Seyedin H, Nemati A, Sadeghifar J, Beigi Nasiri A, Mousavi SM, et al. An analysis of disparities in access to health care in Iran: evidence from Lorestan province. Glob J Health Sci. 2014;6(5):81-6. 23. Sadeghifar J, Seyedin H, Anjomshoa M, Vasokolaei GR, Mousavi SM, Armoun B. Degree of the development of Bushehr province towns in health indicators using numerical taxonomy. Razi Journal of Medical Sciences. 2014;21(118):81-91. Persian 24. Rezaei S, Kazemi Karyani A, Ghahremani E. Development status and access to health care resources using numerical taxonomy and Morris Model: a case study. Scientific Journal of Kurdistan University of Medical Sciences. 2015;20(2):40-50. Persian 25. Loska A. Methodology of variant assessment of exploitation policy using numerical taxonomy tools. Management Systems in Production Engineering. 2015; 2(18): 98-104. 26. Wang Y, Lee H, Lin K. Fuzzy TOPSIS for multi-criteria decision making. International Mathematical Journal. 2003;3:367-9. 27. Bégin M, Berlinguer G, Chatterjee M, Foege WH, Guo Y, Kurokawa K, et al. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008 Nov 8;372(9650):1661-9. 28. Braveman P, Gruskin S. Defining equity in health. J Epidemiol Community Health. 2003;57(4):254-8. 29. Rezaei S, Barouni M, Ghazanfari S, Kazemi Karyani A, Hidarnejad N, Mohammadi B. Disparities in access to health care: case of Iran. Health Med. 2014;8(11):1262-74. 30. Ahmad Kiadaliri A, Najafi B, Haghparast-Bidgoli H. Geographic distribution of need and access to healthcare in rural population: an ecological study in Iran. International Journal for Equity in Health. 2011;10(1):39-48. 31. Abolhallaje M, Mousavi SM, Anjomshoa M, Beigi Nasiri A, Seyedin H, Sadeghifar J, et al. Assessing health inequalities in Iran: a focus on the distribution of health care facilities. Glob J Health Sci. 2014 May 7;6(4):285-91. 32. Omrani-Khoo H, Lotfi F, Safari H, Zargar Balaye Jame S, Moghri J, Shafii M. Equity in distribution of health care resources; assessment of need and access, using three practical indicators. Iran J Public Health. 2013;42(11):1299-308. 33. Tofighi S, Meskarpour Amiri M, Ameriuon A, naseri H. Equity in distribution of intensive care beds in Iran with Gini coefficient and Lorenz curve approach. Yafte. 2011; 12 (2): 75-83. Persian