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Supply chain management in healthcare is evaluated with a particular focus on the distribution of medicines from a wholesaler to clinics. Currently, there are issues with service levels to clinics that need addressing. The value of the paper arises from providing a detailed analysis of a healthcare supply chain in the developing world and Diagnosis the parameter involved in inventory.

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Background and Objectives: Teaching hospitals often face budget limitations and lack of investment. Therefore, the optimal allocation of budget and resources plays an important role in improving the performance and service quality of these hospitals. This research aims to evaluate the performance and determine the efficiency of medical science university hospitals in Tehran. Methods: This study identified and categorized 47 effective factors in the performance assessment of hospital units using the Preference Ranking Organization METHod for Enrichment of Evaluation II (PROMETHEE II) method. Moreover, the performance of 40 medical science university hospitals in Tehran was evaluated using an outcome-based model of data envelopment analysis (DEA) with 4 input and 8 output factors and the assumption of scale-dependent efficiency. The hospitals were also ranked according to the Andersen-Petersen (AP) method. Results: PROMETHEE II results identified 12 factors as the most important in hospital performance evaluation. DEA indicated that 16 hospitals had performance scores below 1 and are thus inefficient. The AP method identified Hospital 28, which had an efficiency value of 4.533, as the best hospital. Conclusion: Given the results of this approach and the identification of a considerable number of teaching hospitals as inefficient hospitals, top managers of medical centers must adopt the necessary planning to improve system performance and realize the optimal application of resources.