Hospital Efficiency in the Eastern Mediterranean Region: A Systematic Review and Meta-Analysis

Abstract

Background: Recent rising costs and shortages of healthcare resources make it necessary to address the issue of hospital efficiency. Increasing the efficiency of hospitals can result in better and sustainable achievement of their organizational goals.The purpose of the present research is to examine hospital efficiency in the Eastern Mediterranean Region (EMR).Methods: This study is a systematic review and meta-analysis of all articles published on hospital efficiency in Eastern Mediterranean countries between January 1999 and May 2018, identified by searching three databases (PubMed through MEDLINE, Web of Science, and Embase) and two search engines (Google and Google Scholar). The reference lists of these articles were checked for additional relevant studies. Fifty articles were finally selected, and data was analyzed through the Comprehensive Meta-Analysis Software (v.2.2.064). Results: Using the random-effects model, the mean hospital efficiency in Eastern Mediterranean hospitals was 0.829 ± 0.026 at 95% CI. Three approaches were used to measure hospital efficiency: data envelope analysis (DEA), stochastic frontier analysis (SFA), and Pabón Lasso Analysis. Different mean and standard deviation values were obtained from DEA (0.428±0.024), DEA and Pabón Lasso Analysis (0.925±0.029), Pabón Lasso Analysis (0.790±0.086) and SFA (0.594±0.056), due to the different inputs and outputs used in these methods. Technical efficiency (TE) was higher in some countries such as Iraq (0.976±0.035), Oman (0.926 ± 0.032), Jordan (0.924±0.060) and Saudi Arabia (0.917±0.023). Conclusion: Efficiency plays a significant role in hospital growth and development. It is therefore important for healthcare managers and policymakers in the EMR to identify the causes of inefficiency, to improve TE and develop cost-effective strategies.