The Efficiency and Budgeting of Public Hospitals: Case Study of Iran

Yusefzadeh, Hassan; Ghaderi, Hossein; Bagherzade, Rafat; Barouni, Mohsen

doi:10.5812/ircmj.4742

Cited by 25 publications

(21 citation statements)

References 7 publications

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“…These have been analyzed in studies conducted in countries outside the EMR, including in HICs [14, 21, 24–26, 33–35, 62]. These studies revealed the significant impact of hospital size and bed numbers on efficiency [87, 88].…”

Section: Discussionmentioning

confidence: 99%

A systematic review on hospital inefficiency in the Eastern Mediterranean Region: sources and solutions

Ravaghi

Afshari

Isfahani

et al. 2019

BMC Health Serv Res

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BackgroundEvaluating hospital efficiency is a process to optimize resource utilization and allocation. This is vital due to hospitals being the largest financial cost in a health system. To limit avoidable uses of hospital resources, it is important to identify the sources of hospital inefficiencies and to put in place measures towards their reduction and elimination. Thus, the purpose of this research is to examine the sources of hospital inefficiency in the Eastern Mediterranean Region, and existing strategies tackling this issue.MethodsIn this study, the electronic databases MEDLINE (via PubMed), Web of Science, Embase, Google, Google Scholar, and reference lists of selected articles, were explored. Studies on inefficiency, sources of inefficiency, and strategies for inefficiency reduction in the Eastern Mediterranean region hospitals, published between January 1999 and May 2018, were identified. A total of 1466 articles were selected using the initial criteria. After further reviews based on the inclusion and exclusion criteria, 56 studies were eligible for this study. The chosen studies were conducted in Iran (n = 35), Saudi Arabia (n = 5), Tunisia (n = 5), Jordan (n = 4), Pakistan (n = 2), the United Arab Emirates, Palestine, Iraq, Oman, and Afghanistan (n = 1 each). These studies were analyzed using content analysis in MAXQDA 10.ResultsThe analysis showed that approximately 41% of studies used data envelopment analysis (DEA) to measure hospital efficiency. Sources of hospital inefficiency were divided into four categories for analysis: Hospital products and services, hospital workforce, hospital services delivery, and hospital system leakages.ConclusionThis study has revealed some sources of inefficiency in the Eastern Mediterranean Region hospitals. Inefficiencies are thought to originate from excess workforce, excess beds, inappropriate hospital sizes, inappropriate workforce composition, lack of workforce motivation, and inefficient use of health system inputs. It is suggested that health policymakers and managers use this evidence to develop appropriate strategies towards the reduction of hospital inefficiency.

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Section: Discussionmentioning

confidence: 99%

A systematic review on hospital inefficiency in the Eastern Mediterranean Region: sources and solutions

Ravaghi

Afshari

Isfahani

et al. 2019

BMC Health Serv Res

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“…Specifically, the authors analysed the cost characteristics of a hospital, concluding that, in general, considering the conclusions concerning economies of scale and economies of scope, larger but more specialized hospitals might be more cost effective [78]. However, the authors found that, in some cases, the reduction of surplus production factors could play a major role in cost reduction of hospitals and health sectors [79]. …”

Section: Resultsmentioning

confidence: 99%

“…Concerning mixed methods , 3 studies were theoretical/descriptive studies [80, 85, 89], and 3 studies were descriptive/empirical studies [79, 84, 88]. One study was a theoretical/descriptive and empirical study [78].…”

Section: Resultsmentioning

confidence: 99%

Efficiency and optimal size of hospitals: Results of a systematic search

Giancotti¹,

Guglielmo²,

Mauro³

2017

PLoS ONE

122

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BackgroundNational Health Systems managers have been subject in recent years to considerable pressure to increase concentration and allow mergers. This pressure has been justified by a belief that larger hospitals lead to lower average costs and better clinical outcomes through the exploitation of economies of scale. In this context, the opportunity to measure scale efficiency is crucial to address the question of optimal productive size and to manage a fair allocation of resources.Methods and findingsThis paper analyses the stance of existing research on scale efficiency and optimal size of the hospital sector. We performed a systematic search of 45 past years (1969–2014) of research published in peer-reviewed scientific journals recorded by the Social Sciences Citation Index concerning this topic. We classified articles by the journal’s category, research topic, hospital setting, method and primary data analysis technique. Results showed that most of the studies were focussed on the analysis of technical and scale efficiency or on input / output ratio using Data Envelopment Analysis. We also find increasing interest concerning the effect of possible changes in hospital size on quality of care.ConclusionsStudies analysed in this review showed that economies of scale are present for merging hospitals. Results supported the current policy of expanding larger hospitals and restructuring/closing smaller hospitals. In terms of beds, studies reported consistent evidence of economies of scale for hospitals with 200–300 beds. Diseconomies of scale can be expected to occur below 200 beds and above 600 beds.

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“…It can be stated that between 50 and 80 percent of public health resources are consumed by hospitals in developing countries with respect to the World Bank study about public hospitals . The size of the hospital's operating costs and lack of sufficient efficiency of healthcare system raise questions on the way of resources consuming by the hospital . When issues related to capital and labor force supply are compounded by the lack of full utilization of existing tools and equipment that is caused by working practices in undeveloped and developing countries, the efficiency rate decreases and it creates a kind of capital and labor force waste in times of scarcity .…”

Section: Introductionmentioning

confidence: 99%

“…1 The size of the hospital's operating costs and lack of sufficient efficiency of healthcare system raise questions on the way of resources consuming by the hospital. 2 When issues related to capital and labor force supply are compounded by the lack of full utilization of existing tools and equipment that is caused by working practices in undeveloped and developing countries, the efficiency rate decreases and it creates a kind of capital and labor force waste in times of scarcity. 3 Therefore, health promotion is an economic and social subject as well as ethical duty, and any type of health service planning should be considered as a part of the health policy approach.…”

Section: Introductionmentioning

confidence: 99%

The economic efficiency of clinical laboratories in public hospitals: A case study in Iran

Alinejhad

Aghlmand

Feizollahzadeh

2019

Clinical Laboratory Analysis

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Introduction Clinical laboratories are identified as one of the most important and expensive units of the health system. Therefore, it is essential to pay attention to these units' cost efficiency. This study purpose was to evaluate the economic efficiency of hospitals' laboratory units affiliated to Urmia University of Medical Sciences (UMSU), in order to assess their performance. Methods This research was a descriptive‐analytic study that was accomplished in 2017. The statistical population of the study included all of the hospitals' clinical laboratories affiliated to UMSU. Moreover, DEA method and Deap2.1 software were used to analyze data. In this study, technical and allocative efficiencies of the studied laboratory units were also calculated in addition to the determination of the economic efficiency of the laboratories. Results The average economic efficiency of clinical laboratories calculated by DEA in 2017 was 0.676. This value was lower than the allocative and technical efficiency scores, which indicates that these units could attain full efficiency by reducing their costs without having any effect on output values. Moreover, about 14 percent of the clinical laboratory units were economically efficient. In addition, it is noteworthy to state that, from total of university hospital laboratories, only three hospitals had no economic excess or deficiency values of inputs. Conclusion Considering that 76% of laboratory units have not been economically efficient, it is necessary for the laboratory managers to consider optimum allocating of resources, with respect to the cost of laboratory equipment and inputs in order to increase their units' economic efficiency.

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The Efficiency and Budgeting of Public Hospitals: Case Study of Iran

Cited by 25 publications

References 7 publications

A systematic review on hospital inefficiency in the Eastern Mediterranean Region: sources and solutions

A systematic review on hospital inefficiency in the Eastern Mediterranean Region: sources and solutions

Efficiency and optimal size of hospitals: Results of a systematic search

The economic efficiency of clinical laboratories in public hospitals: A case study in Iran

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