Two-Step Estimation of the Impact of Contextual Variables on Technical Efficiency of Hospitals: The Case Study of Public Hospitals in Iran

被引：10

作者：

Mohamadi, Efat ^{[1
]}

Kiani, Mohammad Mehdi ^{[1
,2
]}

Olyaeemanesh, Alireza ^{[1
,3
]}

Takian, Amirhossein ^{[1
,2
,4
]}

Majdzadeh, Reza ^{[5
,6
]}

Lotfi, Farhad Hosseinzadeh ^{[7
]}

Sharafi, Hamid ^{[7
]}

Sajadi, Haniye Sadat ^{[8
,9
]}

Goodarzi, Zahra ^{[3
]}

Hekmat, Somayeh Noori ^{[10
]}

机构：

[1] Univ Tehran Med Sci, Hlth Equity Res Ctr HERC, Tehran, Iran

[2] Univ Tehran Med Sci, Sch Publ Hlth, Dept Hlth Management & Econ, Tehran, Iran

[3] Univ Tehran Med Sci, Natl Inst Hlth Res, Tehran, Iran

[4] Univ Tehran Med Sci, Sch Publ Hlth, Dept Global Hlth & Publ Policy, Tehran, Iran

[5] Univ Tehran Med Sci, Community Based Participatory Res Ctr, Tehran, Iran

[6] Univ Tehran Med Sci, Knowledge Utilizat Res Ctr, Tehran, Iran

[7] Islamic Azad Univ, Dept Math, Sci & Res Branch, Tehran, Iran

[8] Univ Tehran Med Sci, Knowledge Utilizat Res Ctr, Tehran, Iran

[9] Univ Tehran Med Sci, Univ Res & Dev Ctr, Tehran, Iran

[10] Kerman Univ Med Sci, Inst Futures Studies Hlth, Res Ctr Hlth Serv Management, Kerman, Iran

来源：

FRONTIERS IN PUBLIC HEALTH | 2022年 / 9卷

关键词：

contextual factors; technical efficiency; DEA; public hospitals; inefficiency; health policy; HEALTH PRODUCTION; PERFORMANCE; DECOMPOSITION; DEA;

D O I：

10.3389/fpubh.2021.785489

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background: Measuring the efficiency and productivity of hospitals is a key tool to cost contamination and management that is very important for any healthcare system for having an efficient system.Objective: The purpose of this study is to examine the effects of contextual factors on hospital efficiency in Iranian public hospitals.Methods: This was a quantitative and descriptive-analytical study conducted in two steps. First, we measured the efficiency score of teaching and non-teaching hospitals by using the Data Envelopment Analysis (DEA) method. Second, the relationship between efficiency score and contextual factors was analyzed. We used median statistics (first and third quarters) to describe the concentration and distribution of each variable in teaching and non-teaching hospitals, then the Wilcoxon test was used to compare them. The Spearman test was used to evaluate the correlation between the efficiency of hospitals and contextual variables (province area, province population, population density, and the number of beds per hospital).Results: On average, the efficiency score in non-teaching hospitals in 31 provinces was 0.67 and for teaching hospitals was 0.54. Results showed that there is no significant relationship between the efficiency score and the number of hospitals in the provinces (p = 0.1 and 0.15, respectively). The relationship between the number of hospitals and the population of the province was significant and positive. Also, there was a positive relationship between the number of beds and the area of the province in both types of teaching and non-teaching hospitals.Conclusion: Multilateral factors influence the efficiency of hospitals and to address hospital inefficiency multi-intervention packages focusing on the hospital and its context should be developed. It is necessary to pay attention to contextual factors and organizational architecture to improve efficiency.

引用

页数：8

共 23 条

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