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Efficiency Measurement for Hospitals Owned by the Iranian Social Security Organisation

Journal of Medical Systems volume 31, pages 166–172 (2007)Cite this article

Abstract

This study used Data Envelopment Analysis (DEA) to examine the relative efficiency of hospitals owned by the Iranian Social Security Organization, which is the second largest institutional source of hospital care in that country. Using data for the year 2002, 26 of the 53 hospitals were deemed to be efficient. Inefficient hospitals had an average score of 90%, implying a potential reduction in all inputs on average by about 10% with no impact on output levels. In addition to the conventional DEA measurement, efficient hospitals were ranked by calculating super-efficiency scores, by identifying weak efficient hospitals, and by determining the frequency of peers. The study provides useful information for improving hospital management, rationalizing resource allocation, and improving services provided by hospitals.

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References

  1. Yaisawarng, S., Performance measurement and resource allocation. In Fox, K. J. (ed.), Efficiency in the Public Sector, Kluwer Academic Publishers, Boston, 2002.

    Google Scholar 

  2. Duckett, S. J., The Australian Health Care System, Oxford University Press, Melbourne, 2003.

    Google Scholar 

  3. Jacobs, R., Alternative methods to examine hospital efficiency: Data envelopment analysis and stochastic frontier analysis. Health Care Manag. Sci. 4:103–115, 2001.

    Article  Google Scholar 

  4. World Bank, Iran National Health Accounts, World Bank, Tehran, 2001.

    Google Scholar 

  5. Department of Financial Affairs, Annual Statistics Report, The Iranian Social Security Organization, Tehran, 2002.

    Google Scholar 

  6. O’Neill, L., Multifactor efficiency in DEA with an application to urban hospitals. Health Care Manag. Sci. 1:19–27, 1998.

    Article  Google Scholar 

  7. Chirikos, T. N., and Sear, A. M., Measuring hospital efficiency: A comparison of two approaches. Health Serv. Res. 34:1389–1408, 2000.

    Google Scholar 

  8. Rosko, M. D., Cost efficiency of US hospitals: A stochastic frontier approach. Health Econ. 10:539–551, 2001.

    Article  Google Scholar 

  9. Kirigia, J. M., Emrouznejad, A., and Sambo, L. G., Measurement of technical efficiency of public hospitals in Kenya: Using data envelopment analysis. J. Med. Syst. 26:39–45, 2002.

    Article  Google Scholar 

  10. Ramanathan, R., Operations assessment of hospitals in the Sultanate of Oman. Int. J. Oper. Prod. Man. 25:39–54, 2005.

    Article  Google Scholar 

  11. Jacobs, R., Smith, P. C., and Street, A., Measuring Efficiency in Health Care: Analytic Techniques and Health Policy, Cambridge University Press, Cambridge, 2006.

    Google Scholar 

  12. Charnes, A., Cooper, W. W., and Rhodes, E. L., Measuring the efficiency of decision-making units. Eur. J. Oper. Res. 2:429–444, 1978.

    MATH  Article  MathSciNet  Google Scholar 

  13. Thanassoulis, E., Introduction to the Theory and Application of Data Envelopment Analysis, Kluwer Academic Publishers, Norwell, 2001.

    Google Scholar 

  14. Hajialiafzali, H., Moss, J. R., and Mahmood, M. A., Efficiency Measurement for Hospitals Owned by the Iranian Social Security Organization, Thesis submitted for the degree of PhD, The University of Adelaide, Adelaide, 2006.

  15. Jensen, G. A., and Morrisey, M. A., The role of physicians in hospital production. Rev. Econ. Statist. 68:432–442, 1986.

    Article  Google Scholar 

  16. Worthington, A. C., Frontier efficiency measurement in health care: A review of empirical techniques and selected applications. Med. Care Res. Rev. 61:135–170, 2004.

    Article  Google Scholar 

  17. Ozcan, Y. A., Luke, R. D., and Haksever, C., Ownership and organizational performance: A comparison of technical efficiency across hospital types. Med. Care 30:780–794, 1992.

    Article  Google Scholar 

  18. McKillop, D. G., Glass, J. C., Kerr, C. A., and McCallion, G., Efficiency in Northern Ireland hospitals: A non-parametric analysis. Econ. Soc. Rev. 30:175–196, 1999.

    Google Scholar 

  19. Ersoy, K., Kavuncubasi, S., Ozcan, Y. A., and Harris, J. M., Technical efficiency of Turkish hospital: DEA approach. J. Med. Syst. 21:67–74, 1997.

    Article  Google Scholar 

  20. Hofmarcher, M. M., Paterson, I., and Riedel, M., Measuring hospital efficiency in Austria: A DEA approach. Health Care Manag. Sci. 5:7–14, 2002.

    Article  Google Scholar 

  21. Sahin, I., and Ozcan, Y., Public sector hospital efficiency for provincial markets in Turkey. J. Med. Syst. 24:307–320, 2000.

    Article  Google Scholar 

  22. Chang, H., Chang, W. J., Das, S., and Shu-Hsing, L., Health care regulation and the operating efficiency of hospitals: Evidence from Taiwan. J. Account Public Pol. 23:483–510, 2004.

    Article  Google Scholar 

  23. Magnussen, J., Efficiency measurement and the opertionalization of hospital production. Health Serv. Res. 31:21–37, 1996.

    Google Scholar 

  24. Al-Shammari, M., A multi-criteria data envelopment analysis model for measuring the productive efficiency of hospitals. Int. J. Oper. Prod. Man. 19:879–890, 1999.

    Article  Google Scholar 

  25. Parkin, D., and Hollingsworth, B., Measuring production efficiency of acute hospitals in Scotland, 1991–1994: Validity issues in data envelopment analysis. Appl. Econ. 29:1425–1433, 1997.

    Article  Google Scholar 

  26. Emrouznejad, A., and Thanassoulis, E., Performance Improvement Management; DEASoftV1, Aston University, Birmingham, 2005.

    Google Scholar 

  27. Andersen, P., and Petersen, N. C., A procedure for ranking efficient units in data envelopment analysis. Manag. Sci. 39:1261–1264, 1993.

    MATH  Article  Google Scholar 

  28. O’Neill, L., and Dexter, F., Methods for understanding super-efficient data envelopment analysis with an application to hospital inpatient surgery. Health Care Manag. Sci. 8:291–298, 2005.

    Article  Google Scholar 

  29. Field, K., and Emrouznejad, A., Measuring the performance of neonatal care units in Scotland. J. Med. Syst. 27:315–324, 2003.

    Article  Google Scholar 

  30. Coelli, T., Prasada Rao, D. S., and Battese, G. E., An Introduction to Efficiency and Productivity Analysis, Kluwer Academic Publishers, Boston, 1998.

    MATH  Google Scholar 

  31. Hlingsworth B., and Parkin, D., The efficiency of Scottish acute hospitals: An application of data envelopment analysis. J. Math. Appl. Med. Bio. 12:161–173, 1995.

    Article  Google Scholar 

  32. Last, J. M., A Dictionary of Epidemiology, Oxford University Press, New York, 2001.

    Google Scholar 

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Acknowledgments

The authors wish to express their gratitude to Dr. Ali Emrouznejad, Dr. Ebrahim Hashemi and Dr. Mohmmadreza Fooladi for their comments and assistance in obtaining the data. We also gratefully acknowledge financial support for the study from the Iranian Social Security Organisation.

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Affiliations

  1. Discipline of Public Health, Schiool of Population Health and Clinical Practice, The University of Adelaide, Adelaide, South Australia, 5005, Australia

    Hossein Hajialiafzali, J. R. Moss & M. A. Mahmood

  2. Health Affairs Department, Iranian Social Security Organisation, Tehran, Iran

    Hossein Hajialiafzali

Authors
  1. Hossein Hajialiafzali
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  2. J. R. Moss
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  3. M. A. Mahmood
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Correspondence to Hossein Hajialiafzali.

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Hajialiafzali, H., Moss, J.R. & Mahmood, M.A. Efficiency Measurement for Hospitals Owned by the Iranian Social Security Organisation. J Med Syst 31, 166–172 (2007). https://doi.org/10.1007/s10916-007-9051-6

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  • DOI: https://doi.org/10.1007/s10916-007-9051-6

Keywords

  • Hospital efficiency
  • Resource allocation
  • Health economics
  • DEA
  • Iran