. Somayeh Mahdiyan; . Ali Dehghani; . Arefe Dehghani Tafti; . Mohsen Pakdaman; . Roohollah Askari
Volume 9, Issue 6 , June 2019, , Pages 1-8
Abstract
BACKGROUND: Given that the need to pay attention to measuring efficiency is considered asone of the main pillars of improving the level of efficiency in hospitals, so this study was ...
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BACKGROUND: Given that the need to pay attention to measuring efficiency is considered asone of the main pillars of improving the level of efficiency in hospitals, so this study was carriedout aimed to determine the mean technical efficiency (The technical efficiency is bound by zeroand one and a score of less than one means that the theatre is inefficient as it could) score interms of type and activity of the hospital, input‑oriented and output‑oriented attitude, returns toscale (In economics, returns to scale and economies of scale are related but different conceptsthat describe what happens as the scale of production increases in the long run, when all inputlevels including physical capital usage are variable (chosen by the firm). The concept of returnsto scale arises in the context of a firm’s production function. It explains the behavior of the rateof increase) in hospitals of Iran using data envelopment analysis (DEA) (DEA is a nonparametricmethod in operations’ research and economics for the estimation of production frontiers. It isused to empirically measure productive efficiency of decision‑making units) and stochastic frontieranalysis (SFA) (SFA is a method of economic modeling. It has its starting point in the stochasticproduction frontier models simultaneously introduced by Aigner, Lovell and Schmidt[1977] andMeeusen and Van den Broeck[1977]MATERIALS AND METHODS: The present study was carried out with a systematic reviewof all studies conducted on measuring efficiency of hospitals in Iran from March 21, 2001 toDecember 21, 2017 using DEA and SFA. Eleven databases were searched using appropriatekeywords and 470 articles were found and evaluated using a checklist, and finally, 24 articleswere entered into the meta‑analysis process. Meta‑analysis was performed using random effectmodel and fixed‑effect model, and study heterogeneity was investigated using Q‑Cochrantest and I2 index. Furthermore, the main reasons of study heterogeneity were identified dueto meta‑regression.RESULTS: The average technical efficiency score of hospitals using DEA and SFA methodwas obtained equal to 0.885 and 0.809, respectively. Furthermore, with regard to the DEAmethod, 0.885, 0.891.0.952 and 0.913 was obtained for input‑oriented and output‑oriented,general and specialized care hospitals and constant returns respectively. With regard to SFAmethod, 0.733, 0.664, 0.641, 0.802, was obtained, and the inputs and outputs affect measuringthe efficiency.DISCUSSION: In contrast, the DEA method can investigate several input and output simultaneouslyand is used as an effective and flexible tool in order to measure the efficiency of the hospital. DEAcan be easily used for calculating efficiency scores based on the proper selection of input andoutput indicators. The data envelopment analysis method and different input and output variableshave been used in most studies conducted in Iran, and Stochastic Frontier Analysis has been lessconsidered. In the present study, the DEA method in governmental educational hospitals showed ahigher efficiency than SFA method in the hospitals under study. But in general, due to lack of optimalefficiency level in the hospital, it is suggested that policymakers determine the hospital efficiencyindices in order to evaluate their efficiency from different dimensions.
CONCLUSION: The average technical efficiency score of hospitals using DEA and SFA method was obtained equal to 0.885and 0.809, respectively. Also, the mean technical efficiency score in terms of input-oriented and output-oriented, general andspecialized care hospitals and constant returns to scale using the DEA method was obtained equal to 0.885, 0.891.0.952 and0.913 and using the SFA method, respectively, it was equal to 0.733, 0.664, 0.641, 0.802, and the inputs and outputs affectingmeasuring the efficiency. There is no significant difference between the mean efficiency score between the two methods, butthe data envelopment analysis method is used more. It is suggested that the hospitals efficiency indicators to be determined inorder to more accurately evaluate the hospitals efficiency.
