The Evaluation of Service Quality in Health Sector with Multi-Criteria Decision Making Methods: A Case Study in Ankara

Öz

The concept of quality in service sector is more related to the customers‟ perception in comparison with production sector. This makes it mandatory for service providers to constantly develop customer-focused quality improvement methods. Multi-Criteria Decision Making (MCDM) Methods contribute to the quality improvements efforts of service providers in their fields by means of defining the values of priorities and choices. In this study, the service quality of hospital types in Ankara province is evaluated by using MCDM methods. The opinions of patients are collected with the help of a questionnaire. The Analytical Hierarchy Process (AHP) is used to determine the weights of the criteria in the questionnaire. Criterion weights and questionnaire responses are used as data for the TOPSIS method based on the 2-tuple Linguistic Representation Model. By means of this method, hospital types (private, training and research, public and university) in Ankara are ranked in respect of their service quality. Private hospitals in Ankara seem to provide services with better quality when compared with other types of hospitals.

Anahtar Kelimeler

• Service quality in health sector,Multi-Criteria Decision Making,2-tuple Linguistic Representation Model,TOPSIS

SAĞLIK SEKTÖRÜNDE HİZMET KALİTESİNİN ÇOK ÖLÇÜTLÜ KARAR VERME YÖNTEMLERİ İLE DEĞERLENDİRİLMESİ: ANKARA’DA BİR UYGULAMA

Öz

Hizmet sektöründe kalite kavramı, üretim sektörüne göre müşterinin algısına çok daha bağımlıdır. Bu da hizmet sunucularının sürekli müşteri odaklı kalite iyileştirme yöntemleri geliştirmesini zorunlu hale getirmektedir. Çok Ölçütlü Karar Verme (ÇÖKV) yöntemleri, önceliklerin ve seçimlerin değerlerinin belirlenmesini sağlayarak hizmet sunucularının kendi alanlarıyla ilgili kalite iyileştirme çalışmalarına katkıda bulunmaktadır. Bu çalışmada, ÇÖKV yöntemleri ile Ankara ilindeki hastane türlerinin hizmet kaliteleri değerlendirilmiştir. Hizmet yararlanıcılarının görüşleri anket yardımı ile toplanmıştır. Ankette yer alan kriterlerin ağırlıklarının belirlenmesi için ise Analitik Hiyerarşi Prosesi (AHP)‟nden yararlanılmıştır. Kriter ağırlıkları ile anket cevapları, 2-Elemanlı Dilsel Temsil Modeline Dayalı Bulanık TOPSIS için veri olarak kullanılmıştır. Bu yöntem ile Ankara'da yer alan hastane türleri (özel, eğitim ve araştırma, devlet ve üniversite) hizmet kalitelerine göre sıralanmıştır. Ankara'da bulunan özel hastanelerin diğer hastane türlerinden daha kaliteli hizmet sunduğu sonucuna ulaşılmıştır. 

Anahtar Kelimeler

• Sağlık sektöründe hizmet kalitesi,Çok Ölçütlü Karar Verme,2-elemanlı Dilsel Temsil Modeli,TOPSIS

Kaynakça

1. Aggelidis, V. P. and Chatzoglou, P. D. (2012) Hospital information systems: Measuring end user computing satisfaction (eucs), Journal of Biomedical Informatics, 45(3), 566-579. doi:10.1016/j.jbi.2012.02.009
2. Akdağ, H., Kalaycı, T., Karagöz, S., Zülfikar, H. and Giz, D. (2014) The evaluation of hospital service quality by fuzzy MCDM, Applied Soft Computing, 23, 239-248. doi:10.1016/j.asoc.2014.06.033
3. Aliman, N. K. and Mohamad, W. N. (2016) Linking service quality, patients‟ satisfaction and behavioral intentions: An investigation on private healthcare in Malaysia, Procedia - Social and Behavioral Sciences, 224, 141-148. doi:10.1016/j.sbspro.2016.05.419
4. Alonso, J. A. and Lamata, T. (2006) Consistency in the analytic hierarchy process: a new approach, International Journal of Uncertainty, 14(4), 445-459. doi:10.1142/S0218488506004114
5. Altuntaş, S., Dereli T. and Yılmaz, M.K. (2012) Multi-criteria decision making methods based weighted SERVQUAL scales to measure perceived service quality in hospitals: a case study from Turkey, Total Quality Management, 23(12), 1379-1395. doi:10.1080/14783363.2012.661136
6. Andaleeb, S. S. (2001) Service quality perceptions and patient satisfaction: a study of hospitals in a developing country, Social Science & Medicine, 52(9), 1359-1370. doi:10.1016/S0277-9536(00)00235-5
7. Ataman, G. ve Yarımoğlu, E. K. (2018) Hastane Türlerine Göre Hasta Memnuniyetini ve Hastane Seçimini Etkileyen Unsurlar, Hacettepe Sağlık İdaresi Dergisi, 21(2), 273-288.
8. Babakus, E. and Mangold, W. G. (1992) Adapting the servqual scale to hospital services: an empirical investigation, Health Services Research, 26(6), 767-786.

9. Buchanan, J., Dawkins, P. and Lindo, J. L. M. (2015) Satisfaction with nursing care in the emergency department of an urban hospital in the developing world: A pilot study, International Emergency Nursing, 23(3), 218-224. doi:10.1016/j.ienj.2015.01.001
10. Büyüközkan, G. and Çifçi, G. (2012) A combined fuzzy AHP and fuzzy TOPSIS based strategic analysis of electronic service quality in healthcare industry, Expert Systems with Applications, 39(3), 2341-2354. doi:10.1016/j.eswa.2011.08.061
11. Büyüközkan, G., Çifçi, G. and Güleryüz, S. (2011) Strategic analysis of healthcare service quality using fuzzy AHP methodology, Expert Systems with Applications, 38(8), 9407- 9424. doi:10.1016/j.eswa.2011.01.103
12. Chang, T. H. (2014) Fuzzy VIKOR method: A case study of the hospital service evaluation in Taiwan, Information Sciences, 271, 196-212. doi:10.1016/j.ins.2014.02.118
13. Chen, C. T. and Hung, W.Z. (2017) Evaluating the Service Quality of Hospital by Using TOPSIS with Interval Type-2 Fuzzy Sets, International Conference on Fuzzy Theory and Its Applications (iFUZZY), Pingtung, TAIWAN, Nov 12-15, 1-5.
14. Grogan,S., Conner, M., Norman, P., Willits, D. and Porter, I. (2000) Validation of a questionnaire measuring patient satisfaction with general practitioner services, Quality in Health Care, 9 (4), 210-215. doi:10.1136/qhc.9.4.210
15. Hantekin, E. ve Akyüz, Y. (2015) TR33 bölgesi devlet hastanelerinin performanslarının bulanık AHP yöntemi ile ölçümü, Optimum Ekonomi ve Yönetim Bilimleri Dergisi, 2(2), 153-169.
16. Hekkert, K. D., Cihangir, S., Kleefstra, S. M., Berg, B. and Kool, R.B. (2009) Patient satisfaction revisited: A multilevel approach, Social Science & Medicine, 69(1), 68-75. doi:10.1016/j.socscimed.2009.04.016
17. Herrera, F. and Martínez, L. (2000a) A 2-tuple fuzzy linguistic representation model for computing with words, IEEE Transactions on Fuzzy Systems, 8(6), 746–752. doi:10.1109/91.890332
18. Herrera, F. and Martínez, L. (2000b) An approach for combining linguistic and numerical information based on the 2-tuple fuzzy linguistic representation model in decision-making, International Journal of Uncertainty, Fuzziness and Knowledge-Based Systems, 8(5), 539-562. doi:10.1142/S0218488500000381
19. Hsu, T. H. and Pan, F. F. C. (2009) Application of Monte Carlo AHP in ranking dental quality attributes, Expert Systems with Applications, 36(2), 2310-2316. doi:10.1016/j.eswa.2007.12.023
20. Hwang C. L. and Yoon K. (1981) Multiple Attribute Decision Making: Methods and Applications, Springer-Verlag, New York.
21. Ishizaka, A. and Labib, A. (2011) Review of the main developments in the analytic hierarchy process, Expert Systems with Applications, 38(11), 14336-14345. doi:10.1016/j.eswa.2011.04.143
22. Jackson, J. L., Chamberlin, J. and Kroenke, K. (2001) Predictors of patient satisfaction, Social Science & Medicine, 52(4), 609-620. doi:10.1016/S0277-9536(00)00164-7
23. Jahanshahloo, G.R., Hosseinzadeh Lotfi, F. and Izadikhah, M. (2006) Extension of the TOPSIS method for decision-making problems with fuzzy data, Applied Mathematics and Computation, 181(2), 1544-1551. doi:10.1016/j.amc.2006.02.057
24. Karaca, Z. (2011). Erzurum‟da sağlık hizmetleri talep tahmini, Yüksek Lisans Tezi, Atatürk Üniversitesi Sosyal Bilimler Enstitüsü, Erzurum.
25. Küçükarslan, S. N. and Nadkarni, A. (2008), Evaluating medication-related services in a hospital setting using the disconfirmation of expectations model of satisfaction, Research in Social and Administrative Pharmacy, 4(1), 12-22. doi:10.1016/j.sapharm.2007.01.001
26. Lu, M. T., Lin, S. W. and Tzeng G. H. (2013) Improving RFID adoption in Taiwan's healthcare industry based on a DEMATEL technique with a hybrid MCDM model, Decision Support Systems, 56, 259-269. doi:10.1016/j.dss.2013.06.006
27. Lupo, T. (2016) A fuzzy framework to evaluate service quality in the healthcare industry: An empirical case of public hospital service evaluation in Sicily, Applied Soft Computing, 40, 468-478. doi:10.1016/j.asoc.2015.12.010
28. Oddershede, A., Carrasco, R. A. and Abu-Muhor, E. B. (2008) Multi-criteria decision model for assessing health service information technology network support using the analytic hierarchy process, Computación y Sistemas, 12(2), 173-182.
29. Otay, Ġ., Oztaysi, B., Onar, S. C. and Kahraman, C. (2017) Multi-expert performance evaluation of healthcare institutions using an integrated intuitionistic fuzzy AHP&DEA methodology, Knowledge-Based Systems, 133, 90-106. doi:10.1016/j.knosys.2017.06.028
30. Ozok, A. A., Wu, H., Garrido, M., Pronovost, P. J. and Gurses, A. P. (2014) Usability and perceived usefulness of personal health records for preventive health care: A case study focusing on patients‟ and primary care providers‟ perspectives, Applied Ergonomics, 45(3), 613-628. doi:10.1016/j.apergo.2013.9.005
31. Saaty, T. L. (2008) Relative measurement and its generalization in decision making why pairwise comparisons are central in mathematics for the measurement of intangible factors the analytic hierarchy/network process, Revista de la Real Academia de Ciencias Exactas, Fisicas y Naturales. Serie A. Matematicas, 102(2), 251-318. doi: 10.1007/BF03191825
32. Shafii, M., Rafiei, S., Abooee, F., Bahrami, M. A., Nouhi, M., Lotfi, F. and Khanjankhani, K. (2016) Assessment of service quality in teaching hospitals of yazd university of medical sciences: using multi-criteria decision making techniques, Osong Public Health Research Perspect, 7(4), 239-247. doi: 10.1016/j.phrp.2016.05.001
33. Shieh, J. I., Wu, H. H. and Huang, K. K. (2010) A DEMATEL method in identifying key success factors of hospital service quality, Knowledge-Based Systems, 23(3), 277-282. doi:10.1016/j.knosys.2010.01.013
34. Sürmeli, G. (2013). Lojistik merkezi seçimine yönelik bulanık çok ölçütlü karar verme modeli: Doğu Anadolu bölgesi için bir uygulama, Yüksek Lisans Tezi, Yıldız Teknik Üniversitesi Fen Bilimleri Enstitüsü, İstanbul.
35. Wei, G. W. (2010) Extension of TOPSIS method for 2-tuple linguistic multiple attribute group decision making with incomplete weight information, Knowledge And İnformation Systems, 25(3), 623-634. doi:10.1007/s10115-009-0258-3
36. Yağcı, M. İ. ve Duman, T. (2006) Hizmet kalitesi-müşteri memnuniyeti ilişkisinin hastane türlerine göre karşılaştırılması: Devlet, özel ve üniversite hastaneleri uygulaması, Doğuş Üniversitesi Dergisi, 7(2), 218-238.
37. Yılmaz, G. F. (2015) Kanser hastalarının hastane seçiminde Elektre yönteminin uygulanması, Tekirdağ S.M.M.M. Odası Sosyal Bilimler Dergisi, (4), 1-27.
38. Zaim, H., Bayyurt, N. and Zaim, S. (2010) Service quality and determinants of customer satisfaction in hospitals: Turkish experience, International Business & Economics Research Journal, 9(5), 51-58.