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Efficiency Measurement of Cardiac Care Units of Isfahan Hospitals in Iran

Abstract

The purpose of this study is to evaluate the performance of the Cardiac Care Units (CCU) of hospitals in Isfahan, Iran. The multi-criteria comparison between the wards of different hospitals is not only useful for the patients but also important for the hospitals management to improve their performance and for the medical policy makers to plan strategic decisions. In this paper, it is intended to consider the aspects of efficiency beyond the traditional evaluation of check list. There are some measures which are used in the existing health audit system and several quantified ratios. Among them the most important ones, based on the patient satisfaction and resource efficiency, have been selected using the weights obtained from their paired comparisons. The factors which have been chosen are divided into two subsets: first, input factors consisting of average number of active beds, medical equipment, personnel (such as doctors, nurses and technicians), and technological capabilities, and second, output factors including bed occupancy percentage, average length of stay, total percentage of survival and performance ratio. The input oriented and variable returns to scale model of Data envelopment analysis (DEA) technique is used to evaluate the efficiency of each CCU ward. The model can be used to find out the causes of inefficiency and how to improve the performance. The method has been applied to evaluate and compare 23 CCUs of hospitals in Isfahan. Although the current health audit system, which uses a check list, has reported 21 of them as first class CCU, DEA model reveals that 11 of them are inefficient. The results may be then used to suggest the improvement strategies based on the output factors.

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Fig. 1

Notes

  1. The super-efficiency model provides a means of discriminating among efficient DMUs, as well as other inefficient DMUs [11].

  2. Charnes, Cooper and Rhodes.

References

  1. Farrell, M. J., The measurement of productive efficiency. J. R. Stat. Soc., Ser. A Stat. Soc. 120(3):252–281, 1957.

    Google Scholar 

  2. Charnes, A., Cooper, W., and Rhodes, E., Measuring the efficiency of decision making units. Eur. J. Oper. Res. 2(6):429–444, 1978.

    MathSciNet  MATH  Article  Google Scholar 

  3. Working Group on Acute Cardiac Care of the European Society of Cardiology, Recommendations for the structure, organization, and operation of intensive cardiac care units. Eur. Heart J. 26:1676–1682, 2005.

    Article  Google Scholar 

  4. Ozcan, Y., Health Care Benchmarking and Performance Evaluation: An Assessment using Data Envelopment Analysis (DEA). Springer: New York, 2008.

    MATH  Book  Google Scholar 

  5. Finkler, M. D., and Wirtschafter, D. D., Cost-effectiveness and data envelopment analysis. Health Care Manage. Rev. 18(3):81–88, 1993.

    Google Scholar 

  6. Puig-Junoy, J., Technical efficiency in the clinical management of critically ill patients. Health Econ. 7:263–277, 1998.

    Article  Google Scholar 

  7. Bahurmoz, A. M. A., Measuring efficiency in primary health care centres in Saudi Arabia. J. KAU: Econ. Adm. 12(2):3–18, 1998.

    Google Scholar 

  8. Kontodimopoulos, N., and Niakas, D., Efficiency measurement of hemodialysis units in Greece with data envelopment analysis. Health Policy. 71:195–204, 2005.

    Article  Google Scholar 

  9. O’Neill, L., and Dexter, F., Evaluating the efficiency of hospitals’ perioperative services using DEA. In: Brandeau, M. L., Sainfort, F., and Pierskalla, W. P., (Eds.), Operations Research and Health Care: A Handbook of Methods and Applications. Kluwer’s International Series: Norwell, pp 147–168, 2004.

  10. Zhu, J., Quantitative Models for Performance Evaluation and Benchmarking: Data Envelopment Analysis with Spreadsheets. Kluwer Academic: Boston, 2002.

    Google Scholar 

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

    MATH  Article  Google Scholar 

Download references

Acknowledgments

The author thank Prof Michael Carter, Head of Centre for Research in Healthcare Engineering, University of Toronto, for crucial help and support with the research.

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Correspondence to Saeedeh Ketabi.

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The writer is indebted to Professor Michael Carter for his valuable advices on the research and the paper.

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Ketabi, S. Efficiency Measurement of Cardiac Care Units of Isfahan Hospitals in Iran. J Med Syst 35, 143–150 (2011). https://doi.org/10.1007/s10916-009-9351-0

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  • DOI: https://doi.org/10.1007/s10916-009-9351-0

Keywords

  • Efficiency
  • Cardiac care unit
  • Data envelopment analysis