سنجش تمرکز فضایی و نابرابری منطقه ای در زیرساخت های حوزه بهداشت و درمان (رهیافت ناپارامتریک)

نوع مقاله : مقالات پژوهشی

نویسندگان

• محمدنبی شهیکی تاش ¹
• عماد کاظم زاده ²

¹ سیستان و بلوچستان

² دانشگاه سیستان و بلوچستان

https://doi.org/10.22067/erd.v22i10.40569

چکیده

امروزه بهداشت، درمان و تأمین سلامت افراد یکی از نیازهای اساسی هر کشوری محسوب می شود. لازمه این امر وجود منابع و زیرساخت های مناسب بهداشتی و درمانی و توزیع عادلانه این امکانات برای تمام افراد آن جامعه می باشد. در این پژوهش ضریب عدالت افقی منطقه ای در حوزه خدمات بهداشتی و درمانی سنجیده شده است. همچنین به چگونگی توزیع فضایی بیمارستان های خصوصی، دولتی و تعداد تخت های فعال در استان های کشور اشاره شده است. در این مقاله با استفاده از شاخص های ناپارامتریک نسبت تمرکز k بنگاه برتر، هرفیندال- هیرشمن، هال- تایدمن، شاخص جامع تمرکز بازاری، هانا- کای و آنتروپی به بررسی توزیع نابرابری افقی و تمرکز تخت های فعال در استان های کشور می پردازیم. نتایج تحقیق نشان می دهد که بیش‌ترین سهم در تمام شاخص های حوزه درمان را استان تهران دارا می باشد و نابرابری منطقه ای در حوزه خدمات بهداشتی بالا است.

کلیدواژه‌ها

• بیمارستان
• تمرکز
• شاخص هرفیندال- هیرشمن
• نابرابری فضایی

عنوان مقاله [English]

Horizontal measuring regional disparities in the health infrastructure ( nonparametric approach )

نویسندگان [English]

• mohammad nabi shahiki tash ¹
• emad kazemzadeh ²

¹ sistan and bbaluchestan

² sistan and baluchestan

چکیده [English]

Extended Abstract
Introduction
Hospitals are the most important and complex social units which are intended to protect the lives of people and to treat and improve them. With the passage of time and progress in science, hospitals have been equipped with more advanced technology and facilities. More active beds in hospitals are indications of specialized manpower, equipment and facilities for the patients, diagnosis of diseases and other services in this regard. In this study, we investigated the distribution of hospitals and active beds in Provinces of Iran.
Theoretical Framework
The spatial concentration of active beds of the hospitals of each Iranian province in 2013 was computed using absolute concentration indices, i.e., concentration ratio of K top provinces, Herfindahl Hirschman Index (HHI), Hall Taydmn Index (HTI), Comprehensive Index of Regional Concentration, Hanna Kai Index and Entropy.
Methodology
To calculate the concentration ratio of K provinces, the sum of share of K largest provinces should be calculated. For Herfindahl Hirschman Index, the share of the sum of the square of province size is considered the share of that province. According to this relationship, provinces with greater shares are given more weight. The Comprehensive Index of Regional Concentration was introduced by Hurat (1970) to overcome the inefficiencies of previous indices. Using this index, it is possible to simultaneously calculate the relative distribution of the share of each province and its absolute size. In Hanna Kai Index, two parameters, i.e., sensitivity and the specific value of market share are used to illustrate the view of the researcher as to the changes in the concentration caused by the entrance and exit of provinces and the share of facilities among the Provinces of Iran. The value of Entropy Index has an inverse relation with the degree of spatial concentration. If the whole share is for one province, the value of the index approaches zero. When the shares of all the provinces are equal, the value of the index will be maximized.
Results & Discussion
Calculating the concentration index of k top provinces, we figured out that spatial concentration of active hospital beds are low regarding that the share of 4 top provinces is about 40 percent of Iran. The value of Herfindahl equals 834.852 this index can be used to conclude that the spatial concentration of the number of active beds in Provinces of Iran are low. The value of Comprehensive Index of Regional Concentration is 0.2892. Because this value is near zero, there is a low concentration in the number of active beds in Provinces of Iran. The value of Hanna Kai Index is 9.916 when =2.5. The value of Entropy Index is 4.289. This index has an inverse relation with the degree of spatial concentration. It can be stated that the concentration of active beds in Provinces of Iran is low according to Entropy Index.
Conclusion and Suggestions
The ratio of spatial concentration of four top provinces, Comprehensive Index of Regional Concentration and Entropy Index are 44 %, 834, 0.062, 0.29 and 4.289 respectively. In addition, Hanna Kai Index for α=0.6, α=1.5 and α=2.5 is 23.86, 15.12 and 9.91 respectively. Regarding the obtained results from these indices, it can be stated that there is a low concentration in the distribution of the number of active beds in Provinces of Iran and that active beds are distributed in the provinces in a relatively appropriate manner. Taking population into consideration, regional inequality is low in Provinces of Iran regarding the distribution of active hospital beds.

کلیدواژه‌ها [English]

• hospital
• Keywords: hospital
• focus
• Hrfyndal- Hirschman Index
• spatial inequality

مراجع

Ahmadiyan, M., Taghavi, M. and Alizadeh, J. (2011). Spatial analysis and assess the level of development Miyandoab city municipalities using fuzzy TOPSIS, Spatial planning, 1(3), 131- 154.(in Persian).

Bai, C., Du, Y., Tao, Z. and Tong, S.Y. (2004). Local Protectionism and Regional Specialization: Evidence from China’s Industries. Journal of International Economics 63.

Falcioglu, P. & Akgungor, S. (2008). Regional Specialization and Industrial Concentration Patterns in the Turkish Manufacturing Industry: An Assessment for the 1980–2000 Period, European Planning Studies Vol. 16, No. 2.

Jalalabadi, A. & Mirjalili, F. (2007). Monopoly and concentration of industry , some industries Case Study 2000- 2005, Journal of Economic Essays, No 7, 197- 232. .(in Persian).

Khodadad kashi, F. (2000). Monopoly , competition and concentration in industrial markets in Iran 1988- 1994, Journal of Commerce, No 15, 83- 116.(in Persian).

Lapteacru, Ion (2012). Assessing Lending Market Concentration in Bulgaria: the Application of a new Measure of Concentration, The European Journal of Comparative Economics, Vol. 9, No. 1, pp. 79- 102.

Macit, Fatih (2012). Recent evidence on concentration and competition in Turkish banking sector, Theoretical and Applied Economics, Vol. XIX, No. 8(573), PP.19- 28.

Meilak, Chris (2008). Measuring Export Concentration: The Implications For Small States, Bank of Valletta Review, No. 37, pp. 35- 48.

Mohamadi, Z., Shakari, M. and Eftekhari, H. (2013). Evaluate the development of the city of Golestan province in health indicators using numerical taxonomy, Fifth Conference on Urban Planning and Management, Mashhad, 1- 12. (in Persian).

Nguyen, Theo Ngoc and Chris Stewart (2013). Concentration and efficiency in the Vietnamese banking system between 1999 and 2009: A structural model approach, Journal of Financial Regulation and Compliance, Volume 21, Issue 3, PP 268-283.

Pavić Kramarić, Tomislava and Maja Kitić (2012). Comparative Analysis of Concentration in Insurance Market in New Member States, World Academy of Science, Engineering and Technology, Vol. 66, pp. 687- 691.

The office of hospital management and clinical service excellence, For health , Ministry of Health and Medical Education .(in Persian).

Zahedi asl, M. (2002). Basics of Social Welfare, Allameh Tabatabai University Press, First Edition. Tehran.(in Persian).

Zangiabadi, A. Amir azdi, T. and Parizadi, T. (2012). Spatial analysis of indicators of health services in the Kurdestan province, Journal of Geography, No 32, 199- 215. (in Persian).

Salehi, H. (1998). Competition, monopoly and concentration of industry : analysis and recommendations, Planning and Budget, No 34, 185- 230. (in Persian).

Sharma, Manoj.k & Harpreet k.Bal (2010). Bank Market Concentration: A Case Study of India, International Review of Business Research Papers, Vol. 6, No. 6, pp.95- 107.