Designing Ranking Model for Health Centers based on Monitoring Standards in East Azerbaijan Province

Abstract

Abstract Introduction: Ranking in primary health care is recognized as a tool to improve quality and efficiency. In this regard, the present study was conducted with the aim of designing and implementing a rating model for comprehensive health service centers in East Azerbaijan Province.

Method: The current cross-sectional study was conducted based on the monitoring indicators of 139 comprehensive health service centers covered by Tabriz University of Medical Sciences. The indicators were standardized using STATA-17 software, then they were categorized into 9 components based on the principal component analysis method and ranked into 5 categories using the chi-means clustering method. To investigate the relationship between the rank of comprehensive health service centers and the structural indicators of the centers, rank regression analysis with a significance level of 0.05 has been used.

Findings: Population and family health indicators, non-communicable diseases and health development and promotion had the greatest impact on the ranking of comprehensive health service centers. Most comprehensive health service centers were 2-star centers. By adjusting other variables, centers on the outskirts of the city (P_Value=0.025 and OR=0.21) and cities with a population of over 20 thousand people compared to rural centers (P_Value>0.001 and OR=0.08) the probability that in the ranks to be placed higher is 79 and 92 percent less, respectively. Also, by adjusting other variables for one person increase in the rural population, the probability of rural centers being ranked higher decreases by 0.01 percent.

Conclusion: The results of the present study showed that rural centers perform better than urban centers. According to the dynamics of the model, important and influential indicators in the ranking of the centers and their weight in the ranking of the centers will be determined every year. Also, the current model can have an impact on improving the performance of comprehensive health service centers and creating competition between centers. Keywords: Ranking, health service centers, monitoring indicators, East Azerbaijan province