scholarly journals Hospital Efficiency Measurement in the West of Iran: Data Envelopment Analysis and Tobit Approach

Author(s):  
Mohamad Yousefi Nayer ◽  
Aliakbar Fazaeli ◽  
Yadollah Hamidi

Abstract Objective The optimal hospital performance and optimal use of resources are among the goals of healthcare policymakers. This study aimed to assess the association between hospital size and hospital area population with technical efficiency in public hospitals . Methods In this descriptive-analytical study, the statistical population consisted of 15 public hospitals in the west of Iran. First, the data envelopment analysis (DEA) method was used to evaluate technical efficiency. Data inputs included staff and beds, and data outputs consisted of the number of surgeries, the number of patients, and the average length of stay. Then, according to the public ownership of all hospitals, their educational and therapeutic activities, as well as their size and population were considered as the environmental factor affecting efficiency. Thus, Tobit regression was applied to measure their effects on efficiency. Results The average technical efficiency of the studied hospitals, the average management efficiency, and the average efficiency of the scale were 0.933, 0.951, and 0.977, respectively. Out of the total evaluated hospitals, six and nine hospitals had an efficiency of less than one and one, respectively. Moreover, the size of the hospital and the population as the environment variable were significant in the Tobit model. Our regression demonstrated that although the size of the hospital is positively associated with its technical efficiency, the hospital population negatively affects hospital efficiency. Conclusion According to the size and area population of the hospitals, they decrease their inputs to maximize their efficacy by optimizing their surplus amounts. It would be possible for policy-makers to examine the least efficient hospitals to correct widespread inefficiency.

2015 ◽  
Vol 5 (1) ◽  
pp. 7 ◽  
Author(s):  
Ashraf Mahate ◽  
Samer Hamidi

Background: Over the past four decades the United Arab Emirates (UAE) has undertaken a series of initiatives to improve the efficiency of hospitals. This study aims to examine the efficiency of private and public hospitals in the UAE. A clearer understanding of the technical efficiency of private and public hospitals will be important in shaping future policy reforms as well as assisting private investors that play an important role in the provision of healthcare within the UAE.Methods: This study employs the Data Envelopment Analysis (DEA) technique to measure the efficiency of both private and public hospitals in the UAE. Efficiency scores are calculated using both Banker, Charnes, and Cooper (BCC) and Charnes, Cooper, and Rhodes (CCR) models. The inputs into the models are number of beds, numbers of doctors, dentists, nurses, pharmacists and allied health staff, and administrative staff, while the outputs are the number of treated inpatients, outpatients, and average length of stay.Results: We find that public hospitals represent about a third of the total number of facilities but treat about 60% of the total number of patients. On the positive side we find that a third of the hospitals in the UAE to be efficient. On the other extreme we find that half the hospitals are less than half as efficient as the top hospital. The average technical efficiency of 96 hospitals is 59% using BCC model and 48% using CCR model. The results show no difference in the average efficiency scores between public and private hospitals, nor between foreign and domestically managed hospitals. We find that there is an almost equal probability to be an efficient or inefficient hospital in any of the emirates.Conclusions: The study contributes to the existing body of literature by establishing baseline technical efficiency scores that could be used in monitoring the efficiency effects of future policy changes. About 41% to 52% of the production factors are wasted during the service delivery process in the hospitals. Using the existing amount of resources, the amount of delivered outputs can be doubled, which can significantly impact patient outcomes. This leads us to believe that the ownership itself and foreign management is not sufficient to bring about improvements in efficiency. Interventions to improve the quality of management in hospitals could help to improve efficiency. National and international benchmarking of hospital performance help to provide more insights on sources of hospital inefficiency.


2020 ◽  
Author(s):  
Efat Mohamadi ◽  
Amirhossein Takian ◽  
Alireza Olyaee Manesh ◽  
Reza Majdzadeh ◽  
Farhad Hosseinzadeh Lotfi ◽  
...  

Abstract Background: Aiming to enhance quality of care and increase efficiency, public hospitals have undergone several reforms in the course of last two decades in Iran. This paper reports the result of a national research that aimed to measure the technical efficiency and productivity change of public hospitals during 2012-2016 in Iran. Methods: We used Extended Data Envelopment Analysis (Extended-DEA) (an innovative modification to conventional DEA) to measure technical efficiency and productivity of 568 public hospitals. Nationally representative data were extracted from the official annual health reports. Data were analysed using GAMS software 24.3. Results: The average efficiency score of all hospitals was 0.733. 10.1% of all hospitals were efficient while 2.68% of them were under 0.2. The Malmquist Productivity Index (MPI) progressed in 49.3% of hospitals, remained constant in 2.3%, while 48.2% of hospitals regressed during 2015-2016. The average of MPI was 1.07 over the period of analysis. Conclusions: Extra efforts seem to be essential to enhance the efficient use of resources and develop appropriate policy solutions and tools. In particular, to increase the return to scale, we advocate the merger of small-size district hospitals towards establishing bigger efficient hospitals in various geographical regions across the country.


2021 ◽  
pp. 1-13
Author(s):  
Yanzhi Bi

Abstract Professional teams are commercial and recreational organizations, and team managers always set their goals to be playing well and benefitting more in a highly competitive environment. In order to measure the ability of the professional teams to make reasonable use of resources and create various outputs, this study employs the Data Envelopment Analysis (DEA) model to measure the efficiencies of 30 Major League Baseball (MLB) teams. The results showed that the inefficiencies were due to pure technical inefficiencies rather than scale effects, and the scale efficiency on average is more higher than the other efficiencies, applying the managers in the Major League Baseball Teams have higher ability of controlling the scale change. Keywords: Major League Baseball, Data Envelopment Analysis, Technical efficiency, Pure technical efficiency, Scale efficiency.


2020 ◽  
Vol 12 (3) ◽  
pp. 121
Author(s):  
Abdullah M. Alsabah ◽  
Hassan Haghparast-Bidgoli ◽  
Jolene Skordis

The recent drop in oil prices has challenged public sector financing in Kuwait. Technical and scale efficiency scores for fifteen public hospitals in Kuwait from 2010 to 2014 were estimated using a two-stage data envelopment analysis (DEA). Technical efficiency scores were regressed against institutional characteristics using Tobit regression to investigate the determinants of efficiency differences in hospitals. Semi-structured interviews were also carried out with fourteen public and private hospital managers to qualitatively explore their perceptions and experience about about factors affecting hospital efficiency. The mean technical efficiency score for all hospitals was 85.8%, an improvement of 2% since 2010. The mean pure technical efficiency score was 79.6%, improving from 75% in 2010 to 81.2% in 2014. The mean scale efficiency score was 91.8%, improving from 87.6% in 2010 to 94.2% in 2014. Only three hospitals were constantly technically and scale efficient. Tobit regression showed that hospital efficiency was significantly associated with the average length of patient stay. Hospitals with more than 400 beds were potentially more technically and scale efficient. The qualitative study revealed that external factors affecting efficiency commonly included implemention of legislative changes and decreasing bureaucracy, while internal factors included increasing bed capacity and improving qualifications and training of human resources. Most public hospitals in Kuwait were not technically and scale efficient, but improvements were observed. Potential factors that affected the efficiency of hospitals in Kuwait were identified. These findings are useful to decision-makers in Kuwait for developing strategies to improve public hospital efficiency.


2021 ◽  
Vol 27 (3) ◽  
pp. 5-17

Going through a series of crisis and post-crisis periods over the last twenty years has had a serious negative impact on public finances around the world, while at the same time the pressure on all levels of public sector governance to deliver more and better public services is growing. This requires a rethinking of the way public services are provided and funded, and efforts to improve performance through more efficient use of resources, and especially at local government level. On the one hand, as a result of global trends in decentralization, more and more spending responsibilities have been transferred to the local public sector and it has become a major provider of public services. On the other hand, the performance of local authorities is also one of the factors determining the decision of individuals and businesses to leave one local unit and choose another that offers better services at lower prices (lower tax burden). The present study aims to measure and evaluate the technical efficiency of Bulgarian municipalities through the application of the non-parametric method Data Envelopment Analysis (DEA). The results of the calculations of the technical efficiency of municipalities in Bulgaria show significant cost efficiency differences between local territorial units. In general, the management at the local level does not use effectively about 25% of their expenditures. The largest number of municipalities operate under increasing return of scale, and these are mostly small local territorial units.


2018 ◽  
Vol 10 (6) ◽  
pp. 141
Author(s):  
Francis Kimani Mwihia ◽  
James Machoki M’ Imunya ◽  
Germano Mwabu ◽  
Urbanus M. Kioko ◽  
Benson B. A. Estambale

The paper uses the DEA technique to estimate efficiency scores in Kenyan public hospitals and then applies the Tobit regression to study inter-hospital variation in the scores. The DEA analysis reveals that small hospitals are more efficient than large hospitals, with efficiency levels ranging from 74-91% in small DMUs and from 57-78% in large DMUs. Tobit regression analysis shows efficiency scores are negatively correlated with the hospital’s distance from the manager’s residence and from the capital city. Internal and external supervisions are suggested as mechanisms for increasing performance of hospitals.


Sign in / Sign up

Export Citation Format

Share Document