Hospital efficiency measurement in the west of Iran: data envelopment analysis and econometric approach

Abstract

Objective Measuring hospital efficiency is one of the way how to use resources.The optimal hospital performance is the goals of healthcare policymakers. This study aimed to the current study was conducted to evaluate the efficiency the current study was conducted to evaluate the efficiency and assess the association between hospital size and hospital area population with technical efficiency in public hospitals. Methods In this descriptive-analytical study, the statistical population consisted of 15 public hospitals in the west of Iran. First, the data envelopment analysis (DEA) method was used to evaluate technical efficiency. inputs included staff and beds, and outputs consisted of the number of surgeries, the number of patients, and the average length of stay. Then, according to the public ownership of all hospitals, their educational and therapeutic activities, as well as their size and population were considered as the environmental factor affecting efficiency. Thus, regression was applied to measure their effects on efficiency. Results The average technical efficiency of the studied hospitals, the average management efficiency, and the average efficiency of the scale were 0.935, 0.961, and 0.987, respectively. Out of the total evaluated hospitals, six and nine hospitals had an efficiency of less than one and one, respectively. Moreover, the size of the hospital and the population as the environment variable were significant in the Tobit model. Our regression demonstrated that although the size of the hospital is positively associated with its technical efficiency, the hospital population negatively affects hospital efficiency. Conclusion According to the size and area population of the hospitals, they decrease their inputs to maximize their efficacy by optimizing their surplus amounts. Tobit regression analysis concludes that hospital size and population covered by the hospital significant effect on hospitals' efficiency.

Approach in Inputs & Outputs Selection of Data Envelopment Analysis (DEA) Efficiency Measurement in Hospital: A Systematic Review

“…While others detailed the model as Radial, Non-Radial and Oriented, Non-Radial and Non-Oriented, and Radial and Non-Radial [23,126]. The majority of the research that were included used Radial DEA models (72 of 89, 80.90%) [46,48–52,54–62,65–77,79,80,82–86,89–94,96–100,102–116,118–124,127–130]. BCC, CCR or combination of both models were the specific model utilized in measuring efficiency via radial change of input and output values.…”

“…In other words, either output expansion or input decrease is the primary evaluation goal. More than half of the studies (55.06%, 49 of 89) [46–48,50–54,58,60,64–69,71–73,75–77,80,91–94,96,98,99,103–107,109–111,113–116,118,121,124,127,128,130,135] applied input-orientated DEA models. The researchers indicated that the choice of input orientation was made to be in line with the fact that the majority of healthcare units aim to minimize inputs given a goal level of output.…”

“…Most frequently, the size, capacity, or functioning of a hospital as a health service is determined by the number of fully staffed hospital or operational beds. 75 of the 89 (84.27%) studies included the number bed (i.e., general, ICU, special) as input in their analysis [48–55,57–62,64–74,76,78–93,95–101,103–109,112–116,118,119,121–125,128–131,133–135]. Seven of these 75 studies (9.33%) utilized variation of multiple beds as their inputs either by type of bed, bed cost, or ratio of bed [61,66,71,78,98,101,129].…”

“…Among the studies, 80 (89.89%) conducted extended analysis in their research [46–56,58–64,66–69,71–77,79–94,96–98,101–116,118–125,128–135]. The type of data applied were almost equally distributed among the studies 51 (57.30%) [47,49,52,58–60,67,70–73,75–77,79,80,83–85,88,91,92,94,96,97,100,101,103,105–109,111,112,114–116,120–122,124,125,127,129–135] used panel data and 38 (42.70%) [46,48,50,51,53–57,61–66,68,69,74,78,81,82,86,87,89,90,93,95,98,99,102,104,110,113,117–119,123,128] used cross sectional data in their research.…”

Efficiency Analysis of Syrian Refugees’ Healthcare Services in Turkey and Other 3RP States

“…DEA is widely applied in healthcare assessment, including hospitals [ 48 ] and health directives [ 49 ]. The choice of model typically corresponds to the researcher’s definition of efficiency [ 15 ].…”