Hospitals' efficiency in Iran: A systematic review and meta-analysis

• Published in: Journal of Education and Health Promotion 2019, Vol.8 (1), p.126-126
• Main Authors: Mahdiyan, Somayeh, Dehghani, Ali, Tafti, Arefe, Pakdaman, Mohsen, Askari, Roohollah
• Format: Article
• Language: English
• Subjects: Data collection; Data envelopment analysis; Efficiency; efficiency improvement; Health care; Health Care Costs; Hospitals; Information Seeking; Keywords; Meta Analysis; Methods; Original; Regression (Statistics); Researchers; Search Strategies; Statistical Analysis; stochastic frontier analysis; Studies; Systematic review
• ISSN: 2277-9531; 2319-6440
• DOI: 10.4103/jehp.jehp_393_18

BACKGROUND: Given that the need to pay attention to measuring efficiency is considered as one of the main pillars of improving the level of efficiency in hospitals, so this study was carried out aimed to determine the mean technical efficiency (The technical efficiency is bound by zero and one and a score of less than one means that the theatre is inefficient as it could) score in terms of type and activity of the hospital, input-oriented and output-oriented attitude, returns to scale (In economics, returns to scale and economies of scale are related but different concepts that describe what happens as the scale of production increases in the long run, when all input levels including physical capital usage are variable (chosen by the firm). The concept of returns to scale arises in the context of a firm's production function. It explains the behavior of the rate of increase) in hospitals of Iran using data envelopment analysis (DEA) (DEA is a nonparametric method in operations' research and economics for the estimation of production frontiers. It is used to empirically measure productive efficiency of decision-making units) and stochastic frontier analysis (SFA) (SFA is a method of economic modeling. It has its starting point in the stochastic production frontier models simultaneously introduced by Aigner, Lovell and Schmidt[1977] and Meeusen and Van den Broeck[1977] MATERIALS AND METHODS: The present study was carried out with a systematic review of all studies conducted on measuring efficiency of hospitals in Iran from March 21, 2001 to December 21, 2017 using DEA and SFA. Eleven databases were searched using appropriate keywords and 470 articles were found and evaluated using a checklist, and finally, 24 articles were entered into the meta-analysis process. Meta-analysis was performed using random effect model and fixed-effect model, and study heterogeneity was investigated using Q-Cochran test and I2 index. Furthermore, the main reasons of study heterogeneity were identified due to meta-regression. RESULTS: The average technical efficiency score of hospitals using DEA and SFA method was obtained equal to 0.885 and 0.809, respectively. Furthermore, with regard to the DEA method, 0.885, 0.891.0.952 and 0.913 was obtained for input-oriented and output-oriented, general and specialized care hospitals and constant returns respectively. With regard to SFA method, 0.733, 0.664, 0.641, 0.802, was obtained, and the inputs and outputs affect measuring the effici