Identification and prioritization of indicators of hospital bed allocation in Iran

Abstract

AbstractThe distribution of hospital beds can be used as an indicator to assess the distribution of health services. This study aimed to determine and prioritize indicators of hospital bed allocation in Iran. In the first phase of the study, we used a scoping review to identify criteria affecting hospital bed allocation. Then, we applied an expert panel and the Delphi method to localize the criteria. Finally, we carried out Analytic Network Process method based on Decision Making Trial and Evaluation Laboratory technique (DANP), to determine the weight and importance of indicators and to evaluate the causal relationship between them. Based on the scoping review, we identified 75 criteria that influence bed allocation. In 2 Delphi cycles, 28 criteria were selected and included in the DANP phase. The population, the presence of a reference hospital in the region, the type of hospital, the common diseases in the region, and the presence of home care services were the variables that had the most interaction with other variables. The variable of home care services was at the highest level of the causal chain. Bed occupancy rate, average length of stay, waiting list, as well as type and level of the hospital had the highest priority in the allocation of hospital beds. Furthermore, given the importance of home care services, policies should be adopted to expand these services nationwide. The indicators identified in this study will be useful for the development of policies aimed at an equitable allocation of hospital beds.