Abstract
Background:Hospitals are the most costly operational and really important units of health system because they consume about 50%-89% of total health resources. Therefore efficient use of resources could help in saving and reallocating the financial and physical resources.Objectives:The aim of this study was to obtain an overview of hospitals' performance status by applying different techniques, to compare similarities and differences between these methods and suggest the most comprehensive and practical method of appraisal for managers and policy makers.Patients and Methods:This is a cross sectional study conducted in all hospitals of Ahvaz (eight hospitals affiliated with Jundishapur University of Medical Sciences and eight non-affiliated hospitals) during 2007 to 2011. Two kinds of data were collected through separate special checklists. Excel 2007 and Windeap 2.1 software were applied for data analysis.Results:The present findings show that the average of bed occupancy rate (BOR) in the studied hospitals was about 65.91 ± 1.16. The maximum number of inefficient hospitals in the present study happened in the years 2007, 2008 and 2010 (four hospitals) but there were two hospitals in the third part of the present graph which had maximum level of efficiency and optimal level of productivity in the years 2007 and 2009. Data Envelopment Analysis (DEA) showed that the mean score of technical efficiency for the studied hospitals is 0.924 ± 0.105 with the minimum of 0.585 ± 0.905 for hospital number 1. Furthermore It shows that only five hospitals (31.25%) reach complete technical efficiency (TE) scores across all five years of 2007-11 (TE = 1).Conclusions:Results of the present and similar studies should be considered for the future planning and resource allocation of Iranian public hospitals. At the same time it is very important to consider need assessment results for each region according to its potentials, population under the coverage and other geographical and cultural indices. Furthermore because of potential limitations of each of the above models it is highly recommended to apply different methods of performance evaluation to reach a complete and real status view of the hospitals for future planning.
Highlights
Hospitals are the most costly operational and really important units of health system because they consume about 50%-89% of total health resources (4)
This graph compartmentalizes the hospitals into four divisions: The first part stands for those hospitals with low bed turn over (BTO) and bed occupancy rate (BOR) implying a surplus in hospital beds against the existing demand, the second sector shows the hospitals with high BTO and low BOR which indicates unnecessary hospitalizations, an oversupply of beds, or using the hospital beds for observing patients
This table indicates that the mean score of technical efficiency for the studied hospitals is 0.924 ± 0.105 with the minimum of 0.585 ± 0.905 for hospital number 1. It shows that only five hospitals (31.25%) reach complete technical efficiency scores in all five years during 2007-2011 (TE = 1)
Summary
Hospitals are the most costly operational and really important units of health system because they consume about 50%-89%. Health sector resources are one of the issues addressed in most developing countries because more than five percent of gross domestic products (GDP) and about five to 10 percent of government's expenditure is usually allocated to this sector (2). As health care costs consume about 5%-. All the institutions providing health services including hospitals will be facing budget issues in the future (3). Hospitals are the most costly operational and really important units of health system because they consume about 50%-89% of total health resources (4). Especially in developing countries are recognized by non-efficient management of resources, low profitability, providing
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