ارزیابی کیفی مکان گزینی مراکز درمانی مطالعه موردی: درمانگاه‌های شهر بم

امروزه موضوع خدمات درمانی یک استراتژی ضروری و اساسی برای ارتقای سلامت همگانی و به شکل گسترده راه‌حلی جهانی به‌منظور بهبود کیفیت زندگی در جهان به شمار می‌رود. به نظر می‌رسد که مراکز درمانی شهر بم نیز ازنظر مکان گزینی در بسیاری از موارد دچار مشکل هستند که این امر می‌تواند ضررهای اقتصادی، مالی و حتی ضررهای جانی غیرقابل جبرانی را نیز در پی داشته باشد. لذا بررسی کیفی مکان گزینی این مراکز می‌تواند به بهبود و ارتقاء کارآیی این مراکز و کاهش مشکلات عدیده آن‌ها منجر شود. هدف پژوهش حاضر ارزیابی کیفی مکان گزینی مراکز درمانی در شهر بم با توجه به شش مولفه دسترسی، هم‌جواری، وابستگی، ظرفیت، ایمنی و آسایش و راحتی می‌باشد. مقاله حاضر ازنظر هدف کاربردی و از نظر روش توصیفی-تحلیلی می‌باشد. شیوه جمع‌آوری اطلاعات در این تحقیق کتابخانه‌ای-اسنادی و مطالعات میدانی است. برای ارزیابی کیفی مکان گزینی مراکز درمانی، اولویت‌بندی و تعیین میزان مطلوبیت هریک از واحدها از مدل ترکیبی ارزیابی تولید وزنی تجمعی (waspas) که در مسائل پیچیده تصمیم‌گیری کارایی بالایی داشته و نتایج حاصل از آن از دقت قابل‌توجهی برخوردار است، بهره گرفته‌شده است. یافته‌های حاصل نشان داد که واحدهای درمانی مورد مطالعه ازنظر مولفه‌های کیفی مکان گزینی دارای تفاوت هستند. به‌طوری‌که کلینیک بقیه‌الله و درمانگاه تخصصی امام حسین (ع) و کلینیک تخصصی امام رضا (ع) دارای شرایط مطلوب ازنظر شاخص‌های مدنظر پژوهش، کلینیک سالک، درمانگاه سلامت و بهداشت دهان و دندان و درمانگاه امام خمینی (ره) دارای وضعیت نیمه مطلوب، درمانگاه زیدیه و درمانگاه فخرآباد در وضعیت نامطلوب قرار دارند. بر اساس نتایج حاصل از پژوهش و مشخص شدن وضعیت مراکز درمانی شهر بم ازنظر بهینه بودن و مطلوبیت در 6 معیار اصلی مورد بررسی، پیشنهاد می‌شود که بر اساس وضعیت هرکدام از مراکز به رفع تعارض‌ها و بهبود شرایط کیفی مکان‌گزینی آن‌ها به‌جای ایجاد مراکز درمانی جدید و هزینه‌بر اقدام شود.

Quality Evaluation of the LocationAllocation of Health CentersCase Study: Bam City Clinics

Extended Abstract IntroductionHealth services land uses are those that if inappropriate locationallocation, they may incur the economic and financial damages and also cause irreparable loss of life. Today, subject of health services is an essential strategy for promoting public health and it is widely regarded as a global solution to improve the quality of life in the world. Medical centers are one of the essential land uses of the city, which are substantial for appropriate accessibility, proper locationallocation and optimal service to the citizens. The increasing of population growth of urban areas has led to enhance the demand for public services, especially health services, and also the need to create these services fairly and on the basis of various environmental, social, economic and physical criteria. Since the establishment of a new health center requires a lot of time and money, this study seeks to analyze and evaluate the locationallocation of health centers by using of qualitative criteria in the city of Bam. It seems that medical centers of Bam also have problems in many cases in terms of locationallocation, which can lead to economic and financial losses and even cause irreparable life damage. Therefore, qualitative assessment of the locationallocation of these centers can improve and promote the efficiency of these centers and reduce their many problems. MethodologyThe present research is applied in terms of purpose and descriptiveanalytical in view point of nature and method. The statistical population of the research is specialized and important clinics of Bam city. The qualitative evaluation of the locationallocation of health care centers was evaluated in six main criteria of accessibility, proximity, dependency, capacity, comfort, convenience and safety and 21 indicators. To analyze and evaluate qualitatively the locationallocation of health centers, the WASPAS model has been used to prioritize and determine the desirability of each unit that performs well on complex decisionmaking issues and the results of it has remarkable accuracy. Results and discussionThe results of data analysis showed that the variance of indices related to Baqiyatallah clinic, except for two indices marginal parking and noise caused by traffic congestion has the highest numerical value this indicates that Baqiyatallah clinic is in suitable condition in all indices except for two indices. After Baqiyatallah Clinic, Imam Hossein and Imam Reza Clinic, respectively, have the highest variance in indices for qualitative locationallocation. In these centers, the variance of the various studied indicators in the qualitative locationallocation and prioritization discussion is in appropriate status and has a high numerical value. Based on the six main considered criteria in this study and based on the results, it can be stated that Imam Reza Clinic, only in the neighborhood criteria (residential, green space, educational, office) and dependency criterion on the other criteria and examined indicators in this center, has the least amount of variance, which can be considered as an indication of the inappropriate locationallocation of the center on the two mentioned criteria. Imam Hossein Clinic also in two criteria (indicators of green space, commercial and bank, office and gardens) and the criterion of comfort and convenience (traffic noise indicator) has the least variance or, in other words, it has the worst optimization among the considered indicators. In this regard, the Salc Clinic, Oral Health Center and Imam Khomeini clinic are in the next rank and semioptimal condition that this is due to the low variance of some indices for these centers. For example, in relation to the Salc clinic, lack of parking, lack of marginal parking and distance from green space have made this center semidesirable. In the case of the center for Oral Health, distance from the green space and failure to comply with the capacity criterion has made the center semidesirable. Among all studied health centers, Fakhrabad and Imamzadeh Zid clinics had the least variance in terms of qualitative indices. These centers, due to inadequate proximity to the religious space (neighborhood mosque), playgrounds and other medical centers, less access to the center, distance from 2nd arterial street, closer to the Bam City fault, long distance from the fire station as well as the location of some municipal facilities near them, are in an undesirable situation. ConclusionThe final results of ranking and qualitative evaluation of locationallocation of health centers in Bam in the form of six main criteria of accessibility, proximity, dependency, capacity, comfort, convenience and safety and 21 indicators indicated that the desirability of each unit was different. Baqiyatallah Clinic, Imam Hossein Specialty Clinic and Imam Reza Specialty Clinic, which have been ranked first to third based on desirability and optimality, have the best desirability condition, Salc Clinic, Oral Health Clinic and Imam Khomeini Clinic have semidesirable condition and Zaydieh Clinic and Fakhrabad Clinic also have undesirable condition.