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Estimation of Technical Efficiency of General Hospitals of Kerman University of Medical Sciences by Data Envelopment Analysis (DEA) Method in 2007
1. Expert in Health Economics
2. Instructor, school of Medical Information and Administration, Kerman University of Medical Sciences, Kerman, Iran 3. Expert in Health Services Management, Kerman University of Medical Sciences, Kerman, Iran
* Corresponding author, e-mail:[email protected]
Abstract
Background & Aims: Hospitals as the largest and most costly operational units in health care system have special importance. The rate of their efficiency can be used as a criterion for the measurement of performance and productivity of resource consumption in hospitals. The purpose of this study was to determine the technical efficiency of general hospitals of Kerman University of Medical Sciences.
Methods: This study is a descriptive - analytic study in which the efficiency of general hospitals in Kerman University of Medical Sciences, including 13 teaching hospitals was determined by using Data Envelopment Analysis (DEA). Data and relevant Statistics were collected from statistics office of the University and Deap2.1 software was used to achieve the objectives of the research. Then the hypotheses of the research were studied by using SPSS software.
Results: The average technical efficiency of studied hospitals in 2007 was 0.912, managerial efficiency was 0.993 and mean scale efficiency was 0.918. In regard to technical efficiency, 7 hospitals had the maximum technical efficiency (1), 4 hospitals had 0.8–1 efficiency and 2 hospitals had the technical efficiency of less than 0.8.
Conclusion: In hospitals with technical efficiency of less than one, the optimal and initial values for staff differed and had personnel surplus. Therefore these hospitals should decrease their initial values for staff in order to achieve the expected optimal performance.
Keywords: Hospital, Technical efficiency, Data envelopment analysis, Managerial efficiency, Efficiency of scale, Constant return to scale, Variable return to scale
References
1. Khalesi N. The survey of management performance in the AZZAHRA Hospital
and Comparison with Standards. J
Manage Inform Iran Univ Med Sci
2001;56: 25-9 [persian].
2. Marandi A. Health in Iran. UNICEF, World Health Organization, Tehran, Report No 23, 1998.
3. Moradi Shahrebabak H, et al. The determination of economic efficiency and effect agent on the Potato Production in Kerman province. Presented at 5th conference of Agricultural Economics. Systan and Balochestan University, Zahedan, 2001.
4. Gannon B. Testing for Variation in Technical Efficiency of Hospitals in Ireland. Economic and Social Review
2005; 36(3): 45-9.
5. Mortimer D. Peacock S. Hospital
Efficiency Measurement: Simple Ratios vs Frontier Methods. Center for Health Program Evaluation, Working Paper 135, August, 2002.
6. Hofler R A, Folland ST. On the technical and allocative efficiency of United States Hospitals: a stochastic frontier approach. J
Health Economics – DRF-JY 1995; 38-9.
7. Parkin M.J. The Measurement of
Productive Efficiency. J Roy Stat Soc
1997; 120(3): 253-8.
8. Somanathan A, Hanson K, Dorabawila T, Perra B. Operating Efficiency in Public Sector health facilities in Sri Lanka:
Measurement and Institutional
Determinants of Performance. Small
Applied Research Paper Health
Economics Policy Series 2000; No.12.
9. Hajialiafzalizadeh H, Moss J.R,
Mahmood M.A. Efficiency Measurement for Hospitals Owned by the Iranian Social Security Organization. J Med Syst 2007;
31: 166–72.
10. Ghaderi H, Goodarzi G. The estimation of technical efficiency in Iran University of Medical Sciences Hospitals with DEA method: 1379-1383, J Health Manage, 2006; 26: 34-7 [Persian].
11. Daliri A. The estimation of technical efficiency in Iran University of Medical Sciences Hospitals with DEA method: 1375-82. Master of Science Thesis, Iran University of Medical Sciences, Tehran, 2005; 26-9 [Persian].
