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Published in: Journal of Medical Systems 3/2007

01-06-2007 | Original Paper

Efficiency Measurement for Hospitals Owned by the Iranian Social Security Organisation

Authors: Hossein Hajialiafzali, J. R. Moss, M. A. Mahmood

Published in: Journal of Medical Systems | Issue 3/2007

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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.
Literature
1.
go back to reference Yaisawarng, S., Performance measurement and resource allocation. In Fox, K. J. (ed.), Efficiency in the Public Sector, Kluwer Academic Publishers, Boston, 2002. Yaisawarng, S., Performance measurement and resource allocation. In Fox, K. J. (ed.), Efficiency in the Public Sector, Kluwer Academic Publishers, Boston, 2002.
2.
go back to reference Duckett, S. J., The Australian Health Care System, Oxford University Press, Melbourne, 2003. Duckett, S. J., The Australian Health Care System, Oxford University Press, Melbourne, 2003.
3.
go back to reference Jacobs, R., Alternative methods to examine hospital efficiency: Data envelopment analysis and stochastic frontier analysis. Health Care Manag. Sci. 4:103–115, 2001.CrossRef Jacobs, R., Alternative methods to examine hospital efficiency: Data envelopment analysis and stochastic frontier analysis. Health Care Manag. Sci. 4:103–115, 2001.CrossRef
4.
go back to reference World Bank, Iran National Health Accounts, World Bank, Tehran, 2001. World Bank, Iran National Health Accounts, World Bank, Tehran, 2001.
5.
go back to reference Department of Financial Affairs, Annual Statistics Report, The Iranian Social Security Organization, Tehran, 2002. Department of Financial Affairs, Annual Statistics Report, The Iranian Social Security Organization, Tehran, 2002.
6.
go back to reference O’Neill, L., Multifactor efficiency in DEA with an application to urban hospitals. Health Care Manag. Sci. 1:19–27, 1998.CrossRef O’Neill, L., Multifactor efficiency in DEA with an application to urban hospitals. Health Care Manag. Sci. 1:19–27, 1998.CrossRef
7.
go back to reference Chirikos, T. N., and Sear, A. M., Measuring hospital efficiency: A comparison of two approaches. Health Serv. Res. 34:1389–1408, 2000. Chirikos, T. N., and Sear, A. M., Measuring hospital efficiency: A comparison of two approaches. Health Serv. Res. 34:1389–1408, 2000.
8.
go back to reference Rosko, M. D., Cost efficiency of US hospitals: A stochastic frontier approach. Health Econ. 10:539–551, 2001.CrossRef Rosko, M. D., Cost efficiency of US hospitals: A stochastic frontier approach. Health Econ. 10:539–551, 2001.CrossRef
9.
go back to reference 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.CrossRef 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.CrossRef
10.
go back to reference Ramanathan, R., Operations assessment of hospitals in the Sultanate of Oman. Int. J. Oper. Prod. Man. 25:39–54, 2005.CrossRef Ramanathan, R., Operations assessment of hospitals in the Sultanate of Oman. Int. J. Oper. Prod. Man. 25:39–54, 2005.CrossRef
11.
go back to reference Jacobs, R., Smith, P. C., and Street, A., Measuring Efficiency in Health Care: Analytic Techniques and Health Policy, Cambridge University Press, Cambridge, 2006. Jacobs, R., Smith, P. C., and Street, A., Measuring Efficiency in Health Care: Analytic Techniques and Health Policy, Cambridge University Press, Cambridge, 2006.
12.
go back to reference Charnes, A., Cooper, W. W., and Rhodes, E. L., Measuring the efficiency of decision-making units. Eur. J. Oper. Res. 2:429–444, 1978.MATHCrossRefMathSciNet Charnes, A., Cooper, W. W., and Rhodes, E. L., Measuring the efficiency of decision-making units. Eur. J. Oper. Res. 2:429–444, 1978.MATHCrossRefMathSciNet
13.
go back to reference Thanassoulis, E., Introduction to the Theory and Application of Data Envelopment Analysis, Kluwer Academic Publishers, Norwell, 2001. Thanassoulis, E., Introduction to the Theory and Application of Data Envelopment Analysis, Kluwer Academic Publishers, Norwell, 2001.
14.
go back to reference 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. 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.
go back to reference Jensen, G. A., and Morrisey, M. A., The role of physicians in hospital production. Rev. Econ. Statist. 68:432–442, 1986.CrossRef Jensen, G. A., and Morrisey, M. A., The role of physicians in hospital production. Rev. Econ. Statist. 68:432–442, 1986.CrossRef
16.
go back to reference 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.CrossRef 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.CrossRef
17.
go back to reference 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.CrossRef 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.CrossRef
18.
go back to reference 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. 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.
19.
go back to reference 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.CrossRef 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.CrossRef
20.
go back to reference Hofmarcher, M. M., Paterson, I., and Riedel, M., Measuring hospital efficiency in Austria: A DEA approach. Health Care Manag. Sci. 5:7–14, 2002.CrossRef Hofmarcher, M. M., Paterson, I., and Riedel, M., Measuring hospital efficiency in Austria: A DEA approach. Health Care Manag. Sci. 5:7–14, 2002.CrossRef
21.
go back to reference Sahin, I., and Ozcan, Y., Public sector hospital efficiency for provincial markets in Turkey. J. Med. Syst. 24:307–320, 2000.CrossRef Sahin, I., and Ozcan, Y., Public sector hospital efficiency for provincial markets in Turkey. J. Med. Syst. 24:307–320, 2000.CrossRef
22.
go back to reference 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.CrossRef 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.CrossRef
23.
go back to reference Magnussen, J., Efficiency measurement and the opertionalization of hospital production. Health Serv. Res. 31:21–37, 1996. Magnussen, J., Efficiency measurement and the opertionalization of hospital production. Health Serv. Res. 31:21–37, 1996.
24.
go back to reference 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.CrossRef 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.CrossRef
25.
go back to reference 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.CrossRef 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.CrossRef
26.
go back to reference Emrouznejad, A., and Thanassoulis, E., Performance Improvement Management; DEASoftV1, Aston University, Birmingham, 2005. Emrouznejad, A., and Thanassoulis, E., Performance Improvement Management; DEASoftV1, Aston University, Birmingham, 2005.
27.
go back to reference Andersen, P., and Petersen, N. C., A procedure for ranking efficient units in data envelopment analysis. Manag. Sci. 39:1261–1264, 1993.MATHCrossRef Andersen, P., and Petersen, N. C., A procedure for ranking efficient units in data envelopment analysis. Manag. Sci. 39:1261–1264, 1993.MATHCrossRef
28.
go back to reference 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.CrossRef 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.CrossRef
29.
go back to reference Field, K., and Emrouznejad, A., Measuring the performance of neonatal care units in Scotland. J. Med. Syst. 27:315–324, 2003.CrossRef Field, K., and Emrouznejad, A., Measuring the performance of neonatal care units in Scotland. J. Med. Syst. 27:315–324, 2003.CrossRef
30.
go back to reference Coelli, T., Prasada Rao, D. S., and Battese, G. E., An Introduction to Efficiency and Productivity Analysis, Kluwer Academic Publishers, Boston, 1998.MATH Coelli, T., Prasada Rao, D. S., and Battese, G. E., An Introduction to Efficiency and Productivity Analysis, Kluwer Academic Publishers, Boston, 1998.MATH
31.
go back to reference 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.CrossRef 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.CrossRef
32.
go back to reference Last, J. M., A Dictionary of Epidemiology, Oxford University Press, New York, 2001. Last, J. M., A Dictionary of Epidemiology, Oxford University Press, New York, 2001.
Metadata
Title
Efficiency Measurement for Hospitals Owned by the Iranian Social Security Organisation
Authors
Hossein Hajialiafzali
J. R. Moss
M. A. Mahmood
Publication date
01-06-2007
Published in
Journal of Medical Systems / Issue 3/2007
Print ISSN: 0148-5598
Electronic ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-007-9051-6

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