Comparison of hospital service performances under COVID-19 pandemics for pilot regions with low vaccination rates.

It is essential to measure the quality and performance of health centers and propose policies in order for health services to continue without interruption during the pandemic period and for the continuous and proper implementation of new procedures in hospitals with COVID-19.The measurement of service quality and performance in hospitals should be provided not only for the smooth flow of health services that are vital for individuals but also for the elimination of hesitations in the treatment and vaccination processes related to COVID-19. Previously, models have been proposed by introducing some criteria to measure and evaluate hospital service performance in some extraordinary conditions, but such a study has not yet been put forward under pandemic conditions. Starting from this point, we aim to fill the gap in the literature by conducting a measurement study for hospitals in the pilot region, where COVID-19 cases are common but vaccination is observed at low rates. For this aim, the evaluation criteria are gathered under basic dimensions as in SERVPERF (Service Performance), which is a widely used tool for measuring service quality and a fuzzy multi-criteria decision analysis is proposed to measure the service performance of state hospitals for a pilot region. In the proposed methodology, the integrated methods consisting of CRITIC-TOPSIS have been extended with fermatean fuzzy sets. Expert opinions are taken via questionaries to determine hospital service performances. Based on the results obtained from the hospitals in the pilot region, the policies and strategies to be adopted by the hospitals serving under pandemic conditions worldwide to increase the service quality have been put forward. Additionally, the sensitivity of the parameters in the problem is measured, and then the validity of the obtained results is also validated. According to the results, assurance is determined as the most important main service performance factor during the pandemic period. So, the managers should develop strategies to address people's concerns about vaccines and increase people's trust in hospitals.