Document Type : Original Article
Authors
- . Touraj Harati Khalilabad
- . Amir Nezami Asl
- . Pouran Raeissi 1
- . Mahboobeh Shali 2
- . Noureddin Niknam 1
1 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences
2 Department of Critical Care Nursing and Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Abstract
INTRODUCTION: Today, it is important to use different indices to measure the performance of
hospitals. This study aimed to investigate and evaluate the performance indicators of military hospitals
and measurement of performance by using the Pabon Lasso model.
METHODS: This was an applied and descriptive‑analytical study that was conducted among five
military hospitals affiliated to the Army of the Islamic Republic of Iran by using data from 2017 to 2018.
Raw data related to performance indicators such as bed occupancy ratio (BOR), average length of
stay (ALoS), and bed turnover rate (BTR) were collected by referring to the hospital medical record
unit. After comparing performance indicators with the standards of the Ministry of Health, the Pabon
Lasso model was used to measure hospitals’ performance.
RESULTS: In general, the average BOR and bed turnover interval rate are higher than that of the
national standard in all hospitals and are in favorable status. However, the average length of stay
in all hospitals was in unfavorable status. Furthermore, one and two hospitals were located in zone
3 in Pabon Lasso graph in the years 2017 and 2018, respectively. Overall, there was no change in
the performance of the hospitals in the study time periods.
CONCLUSION: In general, except for the average length of stay indicator, hospitals had a favorable
performance level. Therefore, planning to improve performance indicators should be at the top of
the programs.
Keywords
- Barnum H, Kutzin J. Public Hospitals in Developing Countries:
Resource Use, Cost, Financing. Baltimore, MD:Johns Hopkins
University Press; 1993.
2. Lotfi F, Bastani P, Hadian M, Hamidi H, Motlagh S, Delavari S.
Performance assessment of hospitals affiliated with Iran university
of medical sciences: Application of economic techniques in health
care area. J Health Adm 2015;18(59): 43‑54
3. Strunk BC, Ginsburg PB, Gabel JR. Tracking health care costs:
Growth accelerates again in 2001: Hospital costs have secured
their place as the leading driver of health care cost increases, for
the second straight year. Health Aff 2002;21 Suppl 1:W299‑310.
4. Duma O, Munteanu L. The resources utilization pattern in a
general university hospital. J Prev Med 2002;10:3‑11.
5. Goshtasebi A, Vahdaninia M, Gorgipour R, Samanpour A,
Maftoon F, Farzadi F, et al. Assessing hospital performance by
the Pabon Lasso model. Iran J Public Health 2009;38:119‑24.
6. Ministry of Health and Medical Education; 2018. [cited
2019 September 07 ] Available from: http://medcare.behdasht.
gov.ir/index.aspx?siteid=312&pageid=36125. [Last accessed on
2019 Sep 25].
7. Hadi M, Sajadi H, Sajadi Z. Is there any method to compare
key indicators of hospital performance simultaneity? Health Inf
Manage 2011;8:8‑75.
8. Gholipour K, Delgoshai B, Masudi‑Asl I, Hajinabi K, Iezadi S.
Comparing performance of Tabriz obstetrics and gynaecology
hospitals managed as autonomous and budgetary units using
Pabon Lasso method. Australas Med J 2013;6:701‑7.
9. Mehrtak M, Yusefzadeh H, Jaafaripooyan E. Pabon lasso and data
envelopment analysis: A complementary approach to hospital
performance measurement. Glob J Health Sci 2014;6:107‑16.
10. National Health Indicators. Ministry of Health and Medical
Education. 2nd ed. Tehran: Ministry of Health and Medical
Education Publication; 2008.
11. Lotfi F, Kalhor R, Bastani P, Shaarbafchi Zadeh N, Eslamian M,
Dehghani MR, et al. Various indicators for the assessment of
hospitals’ performance status: Differences and similarities. Iran
Red Crescent Med J 2014;16:e12950.
12. Moradi G, Piroozi B, Safari H, Esmail Nasab N,
Mohamadi Bolbanabad A, Yari A. Assessment of the efficiency
of hospitals before and after the implementation of health sector
evolution plan in Iran based on Pabon Lasso model. Iran J Public
Health 2017;46:389‑95.
13. Younsi M. Performance of Tunisian public hospitals:
A comparative assessment using the Pabón Lasso model. Int J
Hosp Res 2014;3:66‑159.
14. Dargahi H, Darrudi A, Rezaei Abgoli M. The effect of iran
health system evolution plan on Tehran university of medical
sciences hospitals’ performance indicators: A case study using
the Pabon Lasso model. J Sch Public Health Inst Public Health
Res 2018;16:228‑39.
15. Sadeghifar J, Rezaee A, Hamouzade P, Taghavi‑Shahri S. The
relationship between performance indicators and hospital
accreditation degree in Urmia university of medical sciences.
Biomon J Nurs Midwifery Coll Urmia 2011;9:270‑6.
16. Kavosi Z, Goudarzi S, Almasian‑Kia A. Evaluating of hospital
efficiency by using of Paben Lasso model in Lorestan university
of medical sciences. J All Health Sci Tehran Univ Med Sci
2013;6:365‑75.
17. ArzamaniM, PournaghiS, Seyed‑KatooliS, Jafakesh‑MoghadamA.
The comparison of indicators in educational hospitals of North
Khorasan universities of medical sciences with the standards
of the country in 2011‑2012. J North Khorasan Univ Med Sci
2012;4:513‑22.
18. Zhu Z. Impact of different discharge patterns on bed occupancy
rate and bed waiting time: A simulation approach. J Med Eng
Technol 2011;35:338‑43.
19. Elayyat AH, Sadek A. Hospital utilization pattern in a
hepatogastroenterology department of a research institute
hospital, from 2004 to 2013. J Egypt Public Health Assoc
2016;91:59‑64. - 20. Uy S, Akashi H, Taki K, Ito K. Current problems in national
hospitals of Phnom Penh: Finance and health care. Nagoya J Med
Sci 2007;69:71‑9.
21. Jonaidi N, Sadeghi M, Izadi M, Ranjbar R. Comparison of
performance indicators in one of hospitals of Tehran with national
standards. Iran J Mil Med. 2011 12 (4):223‑8.
22. Mohammadkarim B, Jamil S, Pejman H, Seyyed MH,
Mostafa N. Combining multiple indicators to assess hospital
performance in Iran using the Pabon Lasso model. Australas
Med J 2011;4:175‑9.
23. Nabukeera M, Boerhannoeddin A, Raja Noriza RA. An evaluation
of health centers and hospital efficiency in Kampala capital city
authority Uganda; using Pabon Lasso technique. J Health Transl
Med 2015;18:12‑7.
24. Barfar E, Khammarnia M, Baghbanian A, Panahi M. An
investigation of performance at hospitals affiliated with Zahedan
university of medical sciences; using Pabon Lasso technique.
Medicine Public Health J 2014;1:31‑7.
25. Kalhor R. Assessing hospital performance using Pabon Lasso
analysis. Int J Hosp Res 2013;2:149‑54.
26. Ajlouni M. The relative efficiency of Jordanian public hospitals
using data envelopment analysis Pabon lasso diagram. Global J
Bus Res 2013;7:59‑72.
27. Pabón Lasso H. Evaluating hospital performance through
simultaneous application of several indicators. Bull Pan Am
Health Organ 1986;20:341‑57.
28. SPG media. Dedicated to improving health care. 2008. [cited 2018
March 24]. Available from : //WWW.hospitalmanagement/net.
infor/statistical.index.html. [Last accessed on 2019 Sep 18].
29. Mahapatra P, Berman P. Using hospital activity indicators to
evaluate performance in Andhra Pradesh, India. Int J Health
Plann Manage 1994;9:199‑211.
30. Iswanto A. Measuring Hospital Efficiency Through Pabon Lasso
Analysis: An Empirical Study in Kemang Medical Care (KMC).
Social Science Research Network; 2015.
31. Mohammadi M, Ziapour A, Mahboubi M, Faroukhi A, Amani N.
Performance evaluation of hospitals under supervision of
Kermanshah medical sciences using Pabon Lasso diagram of a
five‑year period (2008‑2012). Life Sci J 2014;11:77‑81.
32. Hafidz F, Ensor T, Tubeuf S. Assessing health facility performance
in indonesia using the Pabón‑Lasso model and unit cost analysis
of health services. Int J Health Plann Manage 2018;33:e541‑e556.
33. Hasan Y, Parviz SS, Bahram N. Health system reform plan and
performance of hospitals: An iranian case study. Mater Sociomed
2017;29:201‑6.
34. NwagbaraVC, RasiahR. Rethinking health care commercialization:
Evidence from Malaysia. Global Health 2015;11:44.
35. ZahiriM, KeliddarI. Performance evaluating in hospitals affiliated
in Ahwaz university of medical sciences based on Pabon Lasso
model. Hospital 2012;11:37‑44.
36. Mehralhasani M, Yazdi‑Feiz‑Abadi V, Barfe‑Shahrbabak T.
Assessing performance of Kerman province`s hospitals using
Pabon Lasso diagram between 2008 and 2010. Q J Hosp
2013;12:99‑107.
37. Asbu E, Walker O, Kirigia J, Zawaira F, Magombo F, Zimpita P,
et al. Technical efficiency of district hospitals in Malawi, an
exploratory assessment using data envelopment analysis. Afr
Health Monit 2012;14 (7): 220‑9..
38. Sajadi H, Sajadi Z, Hadi M. Is there any method to compare
key indicators of hospital performance simultaneity? Health Inf
Manage 2011;8:71‑81.
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