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Hospitals are the most important and costly component of the healthcare system. Therefore, hospital performance evaluation (HPE) is an important issue for the managers of these centres. This paper presents a new approach for HPE that can be used to calculate the efficiency, effectiveness, and productivity of hospitals simultaneously. Efficiency refers to the ratio of inputs and outputs, effectiveness refers to the extent to which outputs align with predetermined goals, and productivity refers to the sum of both efficiency and effectiveness. To this end, a Data Envelopment Analysis (DEA) model is developed to simultaneously measure the efficiency, effectiveness, and productivity (DEA-EEP) of hospitals. DEA is a linear programming technique that in its traditional form, calculates the performance of similar decision-making units (DMUs) that have both inputs and outputs. In this study, the inputs are the number of health workers, the number of other staff, and the number of patient beds; while the outputs are the bed occupancy rate and the bed turnover rate. A target value is set for each output to measure the effectiveness of hospitals. The advantage of the developed model is the ability to provide a solution for non-productive units so that they can improve their performance by changing their inputs and outputs. In the case study, data of 11 hospitals in Tehran were evaluated for a 3-year period. Based on the results, some hospitals experienced an upward trend in the period, but the efficiency, effectiveness, and productivity scores of most hospitals fluctuated and did not have a growing trend. This indicates that although most hospitals sought to improve the quality of their services, they needed to take more serious steps.

Decision-making processes in different organizations often have a hierarchical and multilevel structure with various criteria and sub-criteria. The application of hierarchical decision-making has been increased in recent years in many different areas. Researchers have used different hierarchical decision-making methods through mathematical modeling. The best-worst method (BWM) is a multi-criteria evaluation methodology based on pairwise comparisons. In this paper, we introduce a new hierarchical BWM (HBWM) which consists of seven steps. In this new approach, the weights of the criteria and sub-criteria are obtained by using a novel integrated mathematical model. To analyze the proposed model, two numerical examples are provided. To show the performance of the introduced approach, a comparison is also made between the results of the HBWM and BWM methodologies. The analysis demonstrates that HBWM can effectively determine the weights of criteria and sub-criteria through an integrated model.

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