Technical Efficiency Of Post-Disaster Health Services Interventions: The 2023 Kahramanmaraş Earthquake In Turkey

Öz

Aim: In order to meet the most urgent needs of the regions affected by the biggest earthquake of the century, government, national and international actors have made enormous efforts. However, some international studies evaluating the effectiveness of previous disaster relief efforts have expressed that inefficient use of resources in the disaster relief process should be a matter of concern. The main purpose of this study is to obtain evidence to support post-earthquake healthcare interventions and to establish a reference on earthquake relief. Methods: The data of the study covers the period from 6 February to 16 February 2023 and was obtained from the official daily reports of the Health Disaster and Coordination Centre Unit (SAKOM) of the Ministry of Health. The data consisted of allocations of rescue units, human resources, workload and other information recorded in official daily reports. In addition, Data Envelopment Analysis (DEA) method was used to evaluate the technical efficiency of health services provided in 10 provinces affected by the earthquake in the first emergency period of the Kahramanmaraş-centered earthquake. Results: The technical efficiency scores of the health services provided in the earthquake-affected provinces are analysed, it is seen that while the average technical efficiency was 52% (SD: 0.30) on the 5th day of the earthquake, it increased significantly to 80% (SD: 0.21) on the 10th day. Conclusion: This result shows that health services in earthquake zones have started to be provided more efficiently over time. The rapid normalisation of health services in earthquake zones is an important indicator for the performance of disaster management and crisis response teams. Despite the extensive research on earthquake response and health services individually, there's a noticeable gap in literature explicitly exploring the relationship between the two. This lacuna in research is particularly evident when it comes to examining the efficiency of health services during seismic disasters.

Anahtar Kelimeler

• public health
• emergency
• earthquake
• disaster
• sustainability

Kaynakça

1. Akbari, M. E., Asadi Lari, M., Montazeri, A., Aflatunian, M. R., & Farshad, A. A. (2005). Evaluation of health system responsiveness to the 2003 Bam, Iran, Earthquake. Earthquake Spectra, 21(1_suppl), 469-474.
2. Ardagh, M. W., Richardson, S. K., Robinson, V., Than, M., Gee, P., Henderson, S., ... & Deely, J. M. (2012). The initial health-system response to the earthquake in Christchurch, New Zealand, in February, 2011. The Lancet, 379(9831), 2109-2115.
3. Armenian, H. K., Melkonian, A., Noji, E. K., & Hovanesian, A. P. (1997). Deaths and injuries due to the earthquake in Armenia: a cohort approach. International journal of epidemiology, 26(4), 806-813.
4. Chapin, E., Daniels, A., Elias, R., Aspilcueta, D., & Doocy, S. (2009). Impact of the 2007 Ica earthquake on health facilities and health service provision in southern Peru. Prehospital and disaster medicine, 24(4), 326-332.
5. Ersoy, K., Kavuncubasi, S., Ozcan, Y. A., & Harris II, J. M. (1997). Technical efficiencies of Turkish hospitals: DEA approach. Journal of Medical Systems, 21, 67-74. Fleming, P., O'Donoghue, C., Almirall-Sanchez, A., Mockler, D., Keegan, C., Cylus, J., ... &
6. Thomas, S. (2022). Metrics and indicators used to assess health system resilience in response to shocks to health systems in high income countries-A systematic review. Health Policy.
7. Gülnur İlgün & Bayram Şahin (2022) Investigation of factors affecting efficiency of primary healthcare in Turkey with two-stage data envelopment analysis, International Journal of Healthcare Management, 15:1, 45-51,
8. Liu, X., Tang, B., Yang, H., Liu, Y., Xue, C., & Zhang, L. (2015). The technical efficiency of earthquake medical rapid response teams following disasters: The case of the 2010 Yushu earthquake in China. International Journal of Environmental Research and Public Health, 12(12), 15390-15399.

9. Liu, X., Liu, Y., Zhang, L., Liang, W., Zhu, Z., Shen, Y., ... & Liu, Z. (2013). Mass aeromedical evacuation of patients in an emergency: experience following the 2010 yushu earthquake. The Journal of Emergency Medicine, 45(6), 865-871.
10. Nickerson, J. W., Hatcher-Roberts, J., Adams, O., Attaran, A., & Tugwell, P. (2015). Assessments of health services availability in humanitarian emergencies: a review of assessments in Haiti and Sudan using a health systems approach. Conflict and health, 9, 1-11.
11. Robertson, A. G., Griffiths, E. K., Norton, I., & Weeramanthri, T. S. (2011). Disaster response from Australia: What is the role of Forward Teams?. Travel medicine and infectious disease, 9(5), 249-252.
12. Rogers, H. L., Barros, P. P., Maeseneer, J. D., Lehtonen, L., Lionis, C., McKee, M., ... & Kringos, D. (2021). Resilience testing of health systems: How can it be done?. International journal of environmental research and public health, 18(9), 4742.
13. Saberian, P., Kolivand, P. H., Hasani-Sharamin, P., Dadashi, F., & Farhoud, A. R. (2019). Iranian emergency medical service response in disaster; report of three earthquakes. Advanced journal of emergency medicine, 3(2).
14. Saghafinia, M., Araghizade, H., Nafissi, N., & Asadollahi, R. (2007). Treatment management in disaster: A review of the Bam earthquake experience. Prehospital and disaster medicine, 22(6), 517-521.
15. Subedi, S., Sharma, G. N., Dahal, S., Banjara, M. R., & Pandey, B. D. (2018). The health sector response to the 2015 earthquake in Nepal. Disaster medicine and public health preparedness, 12(4), 543-547.
16. Thabrani, G., Irfan, M., Mesta, H. A., & Arifah, L. (2019, May). Efficiency analysis of local government health service in West Sumatra province using data envelopment analysis (DEA). In 1st International Conference on Economics, Business, Entrepreneurship, and Finance (ICEBEF 2018) (pp. 783-789). Atlantis Press.
17. Yildirim, C., Kacak, H., Yildirim, S., & Kavuncubasi, S. (2019). Comprehensive Efficiency Assessment of Turkish Teaching Hospitals: Technical, Pure Technical and Scale Efficiencies with Data Envelopment Analysis. Journal of Applied Business & Economics, 21(3).
18. Zeblllos, J. L. (1986). Health aspects of the Mexico earthquake—19th September. Disasters, 10, 2.
19. Zhang, L., Liu, Y., Liu, X., & Zhang, Y. (2011). Rescue efforts management and characteristicsof casualties of the Wenchuan earthquake in China. Emergency medicine journal, 28(7), 618-622