文章基本信息

标题：The Health Sector Evolution Plan and the Technical Efficiency of Public Hospitals in Iran
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作者：Edris KAKEMAM ; Hossein DARGAHI
期刊名称：Iranian Journal of Public Health
印刷版ISSN：2251-6085
电子版ISSN：2251-6093
出版年度：2019
卷号：48
期号：9
DOI：10.18502/ijph.v48i9.3028
语种：English
出版社：Tehran University of Medical Sciences
摘要：Background: Iranian public hospitals have been excessively changing during the healthcare reform since 2014. This study aimed to examine the technical efficiency of public hospitals during before and after the implementation of Health Sector Evolution Plan (HSEP) and to determine whether, and how, efficiency is affected by various factors. Methods: Forty-two public hospitals were selected in Tehran, Iran, from 2012 to 2016. Data envelopment analysis was employed to estimate the technical and scale efficiency sample hospitals. Tobit regression was used to relate the technical efficiency scores to seven explanatory variables in 2016, the last year. Results: Overall, 24 (57.1%), 26 (61.9%), 26 (61.9%), 24 (57.1%) and 21 (50%) of the 42 sample hospitals ran inefficiently in 2012 to 2016, with average technical efficiency of 0.859, 0.836, 0.845, 0.905 and 0.934, respectively. The average pure technical efficiency in sample hospitals increased from 0.860 in 2010 (before the HSEP) to 0.944 in 2012 (after the HSEP). Tobit regression showed that average length of stay had a negative impact on technical efficiency of hospitals. In addition, bed occupancy rate, ratio of beds to nurses and ratio of nurses to physicians assumed a positive sign with technical efficiency. Conclusion: Despite government support, public hospitals operated relatively inefficien. Managers can enhance technical efficiency by increasing bed occupancy rate through shortening the average length of stay, proportioning the number of doctors, nurses, and beds along with service quality assurance.
关键词：Data envelopment analysis; Efficiency; Health care reform; Public hospital; Iran