Abstract
Iran has performed Health Transformation Plan (HTP) from 2014 to obtain its defined goals. This study assesses and compares university and non-university hospitals' efficiency and productivity in Kerman provinces, Iran. The data of 19 selected hospitals, two years before and two years after Health Transformation Plan, was collected in this cross-sectional study. These data included the variables of physician and nurse number, and active beds as inputs and bed occupancy rate and inpatient admission adjusted with the length of stay as outputs. Data Envelopment Analysis method used to measure hospital efficiency. Malmquist Productivity Index is used to measure the efficiency change model before and after the plan. The efficiency and effect of the plan on hospitals' efficiency and productivity were assessed using R software. The results indicated that all hospitals' average efficiency before the HTP was 0.843 and after the HTP was increased to 0.874. However, it was not significant (P>0.05). Productivity also had a decreasing trend. Based on the DEA method results, it was found that university and non-university hospitals' efficiency and productivity did not increase significantly after the HTP. Therefore, it is recommended that attention be paid to hospitals' performance indicators regarding how resources are allocated and decisions made.
Highlights
The increasing healthcare costs have persuaded the governments and health policymakers to increase productivity and efficiency [1]
The results of paired t-test and Wilcoxon test showed that Health Transformation Plan (HTP) has significantly increased the inputs of nurses and active beds and the inputs of bed occupancy rate and the number of inpatient admissions adjusted with stay length in university hospitals (P
Bed occupancy rate and the number of inpatient admissions adjusted with stay length have increased by 15% and 20% after HTP, respectively among the positive effects of HTP
Summary
The increasing healthcare costs have persuaded the governments and health policymakers to increase productivity and efficiency [1]. Health system reforms more or less have left behind favorable effects. After performing a health transformation program, Turkey’s country has gained significant improvements regarding performance indices [2]. By attention to overall missions and upstream documents, especially Iran’s 20 years’ vision document and Iran supreme leader policies, the Iran Ministry of Health and Medical Education launched Health Transformation Plan(HTP) in 2014 [3].
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