Volume 5, Issue 4 (10-2021)
EBHPME 2021, 5(4): 222-233 |
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Hamed Dehnavi 
, Mehdi Rezaee , Mohammad Farough Khosravi , Mahdi Gharasi Manshadi , Jalal Saeidpour *
, Mehdi Rezaee , Mohammad Farough Khosravi , Mahdi Gharasi Manshadi , Jalal Saeidpour *
Health Information Management Research Center, Tehran University of Medical Sciences, Tehran, Iran , jsaeidpour@tums.ac.ir
Abstract: (1325 Views)
Background: Surgery wards account for a significant portion of hospital costs, followed by patient costs. Improving surgery wards' performance plays a major role in enhancing the accountability and efficiency of the hospital. This study aimed to evaluate the performance of inpatient surgical wards at the hospitals affiliated with Tehran University of Medical Sciences(TUMS).
Methods: A descriptive, cross-sectional, retrospective study was performed at all hospitals affiliated with TUMS in 2018. To measure the efficiency of these wards, three indicators have been considered; bed occupancy rate, the average length of stay, and bed turnover. Data have been analyzed using Excel software based on the Pabon Lasso model .
Results: Among the 15 active surgical departments, 5 (33.31 %) were categorized in quadrant three, including ophthalmology, obstetrics and gynecology, vascular and trauma surgery, plastic surgery, and infertility department. The oral and maxillofacial surgery and general surgery departments were the poorest in their performance and located in quadrant one. Ten surgical wards out of 38 (26.33 %) have reported a satisfactory performance.
Conclusion: Understanding and comparing the performance of clinical departments is also useful in making decisions for standardizing the patterns of health services delivery, evidence-based management in health care centers, and enhancing accountability in the health system. It is suggested that managers revise the departments in the inefficient area to reduce the number of inefficient departments or attract more patients by marketing, diversifying services, and increasing the quality of services.
Methods: A descriptive, cross-sectional, retrospective study was performed at all hospitals affiliated with TUMS in 2018. To measure the efficiency of these wards, three indicators have been considered; bed occupancy rate, the average length of stay, and bed turnover. Data have been analyzed using Excel software based on the Pabon Lasso model .
Results: Among the 15 active surgical departments, 5 (33.31 %) were categorized in quadrant three, including ophthalmology, obstetrics and gynecology, vascular and trauma surgery, plastic surgery, and infertility department. The oral and maxillofacial surgery and general surgery departments were the poorest in their performance and located in quadrant one. Ten surgical wards out of 38 (26.33 %) have reported a satisfactory performance.
Conclusion: Understanding and comparing the performance of clinical departments is also useful in making decisions for standardizing the patterns of health services delivery, evidence-based management in health care centers, and enhancing accountability in the health system. It is suggested that managers revise the departments in the inefficient area to reduce the number of inefficient departments or attract more patients by marketing, diversifying services, and increasing the quality of services.
Type of Study: Original article |
Subject:
Healt care Management
Received: 2021/04/18 | Accepted: 2021/10/28 | Published: 2021/10/28
Received: 2021/04/18 | Accepted: 2021/10/28 | Published: 2021/10/28
References
1. Pourmohammadi K, Shojaei P, Rahimi H, Bastani P. Evaluating the health system financing of the Eastern Mediterranean Region (EMR) countries using Grey Relation Analysis and Shannon Entropy. Cost Effectiveness and Resource Allocation. 2018; 16(1): 31. [DOI: 10. 1186/s12962-018-0151-6]
2. Scott A, Yong J. Do new workforce roles reduce waiting times in ED? A difference-in-difference evaluation using hospital administrative data. Health Policy. 2015; 119(4): 488-93.
3. Tripathi CB, Kumar R, Sharma RC, Agarwal R. Assessment of performance of services in a tertiary care Neuropsychiatric Institute using Pabon Lasso model. Asian Journal of Medical Sciences. 2016; 7(6): 69-74.
4. Adham D, Panahi M, Barfar IS, Ameri H, Sadeghi G, Salarikhah E. Contemporary use of hospital efficiency indicators to evaluate hospital performance using the Pabon Lasso Model. European Journal of Business Social Sciences. 2014; 3(2): 1-8.
5. Najafi S, Mahmoudi Gh, Dabbaghi F, Moradian M. Comparison of performance of hospitals in Mazandaran Province with the approach of the Pabon Lasso model and based on the type of ownership. Journal oF Organizational Behavior Research. 2018; 3(2): 2-4.
6. Ravaghi H, Afshari M, Isfahani P, Bélorgeot VD. A systematic review on hospital inefficiency in the Eastern Mediterranean Region: Sources and solutions. BMC Health Services Research. 2019; 19(1): 830.
7. Amoozadeh A, Shahverdi R, Rezaei Balf F. Comparison of relative efficiency of hospitals affiliated to Babol and Mazandaran Universities of Medical Sciences before and after health development plan with data envelopment analysis method. Journal of Babol University of Medical Sciences. 2018; 20(1): 68-4. [In Persian]
8. Shaw C. How can hospital performance be measured and monitored?: World Health Organization Regional Office for Europe; 2003. Available from URL: https://www.euro.who.int/ en/data-and-evidence/evidence-informed-policy-making/publications/pre2009/how-can-hospital-performance-be-measured-and-monitored. Last access: May 10, 2021.
9. Bouckaert N, Van den Heede K, Van de Voorde C. Improving the forecasting of hospital services: A comparison between projections and actual utilization of hospital services. Health Policy. 2018 122(7): 728-36. [DOI: 10.1016/j.healthpol. 2018.05.010]
10. Mohammadi M, Ziapoor A, Mahboubi M, Faroukhi A, Amani N, Hydarpour F, et al. Performance evaluation of hospitals under supervision of Kermanshah Medical Sciences using pabonlasoty diagram of a five-year period (2008-2012). J Life Sci J. 2014; 11(1): 77-81.
11. Parvaresh M, Esfandnia A. Investigation of Iranian Hospitals' efficiency using Pabon Lasso model: Systematic review. Annals of Tropical Medicine Public Health. 2017; 10(4): 884. [DOI: 10.4103/ATMPH.ATMPH_238_17]
12. Barouni M, Amiresmaieli MR, Shahravan A, Amini S. The efficiency assessment of dental units using data envelopment analysis approach: The case of Iran. Iran J Public Health. 2017; 46(4): 552.
13. Bahadori MK, Izadi AR, Ghardashi F, Ravangard R, Hosseini SM. The evaluation of hospital performance in Iran: a systematic review article. Iranian Journal of Public Health. 2016; 45(7): 855-66.
14. Mosadeghrad AM, Afshari M. The impact of quality management on income of operating theatre in a hospital: brief report. Tehran University Medical Journal. 2018; 75(10): 768-72. [In Persian]
15. Sadghiani A. Textbook of Hospital Organization and Management. 1 ed. Tehran: Jahan rayaneh; 1999. p151-9.
16. Hooshmand E, Zomorodi Niat H, Ebrahimipour H, Esmaili HA, Vafaee Najar A. Designing a performance evaluation model based on balanced score card and analytic hierarchy process methods: Montaserieh Hospital. 2018; 7(2).
17. Taslimi MS, Zayandeh M. Challenges of hospital performance assessment system development: Literature review. Hakim Health Systems Research Journal. 2013; 16(1): 35-41.
18. Varabyova Y, Schreyögg J. International comparisons of the technical efficiency of the hospital sector: Panel data analysis of OECD countries using parametric and non-parametric approaches. Health Policy. 2013; 112(1-2): 70-9. [DOI: 10.1016/j.healthpol.2013.03.003]
19. Farrell MJ. The measurement of productive efficiency. Journal of the Royal Statistical Society: Series A (General). 1957; 120(3): 253-90.
20. Haji Ali Afzali H, Moss JR, Mohammad Afzal M. A conceptual framework for selecting the most appropriate variables for measuring hospital efficiency with a focus on Iranian public hospitals. Health Serv Manage Res. 2009; 22(2): 81-91. [DOI: 10.1258/hsmr.2008.008020]
21. Pabon Lasso H. Evaluating hospital performance through simultaneous application of several indicators. 1986. Avaiable from URL: https://iris.paho.org/bitstream/handle/10665.2/27221/ev20n4p341.pdf?sequence = 1. Last access: May 10, 2021.
22. Bahadori Mk, Sadeghifar J, Hamouzadeh P, Hakimzadeh SM, Nejati M. Combining multiple indicators to assess hospital performance in Iran using the Pabon Lasso model. Australas Med J. 2011; 4(4): 175. [DOI: 10.4066/AMJ. 2011.620]
23. Mehrtak M, Yusefzadeh H, Jaafaripooyan E. Pabon Lasso and Data Envelopment Analysis: A complementary approach to hospital performance measurement. Glob J Health Sci. 2014; 6(4): 107. [DOI: 10.5539/gjhs.v6n4p107]
24. Goshtasebi A, Vahdaninia M, Gorgipour R, Samanpour A, Maftoon F, Farzadi F, et al. Assessing hospital performance by the Pabon Lasso model. Iranian Journal of Public Health. 2009; 38(2): 119-24.
25. Naghavian M, Naghshine A, Abdi M, Jahani MA. The evaluation of performance indicators in the health care centers of Babol University of Medical Sciences by the Pabon Lasso model (2011-2014). Journal of Babol University of Medical Sciences. 2015; 17(3): 76-82.
26. Miraki T, Rezaei S, Jahanmehr N, Mohammadi M, Gharibi F. Assessment of performance of the hospitals of Kurdistan University of Medical Sciences by use of Pabon Lasso model (2007-2011). Scientific Journal of Kurdistan University of Medical Sciences. 2014; 19(1): 114-23. [In Persian] [DOI: 10.22102/19.1.114]
27. Mosadeghrad AM, Dehnavi H. Evaluation of hospital performance in Iran: A systematic review and meta-analysis. Payesh. 2018; 17(6): 603-15. [In Persian]
28. Moghadamnia AA, Jahani MA, Bijani A, Yaminfirooz M, Naghshineh A, Mohammadnia K. Evaluation of performance indicators and frequency of patient referrals in the hospitals affiliated to Babol University of Medical Sciences in 2013. Journal of Babol University of Medical Sciences. 2016; 18(5): 61-9.
29. Casalino E, Perozziello A, Choquet C, Curac S, Leroy C, Hellmann R. Evaluation of hospital length of stay and revenues as a function of admission mode, clinical pathways including observation unit stay and hospitalization characteristics. Health Services Management Research. 2018; 32(1): 16-25.
30. Hashemi N, Heidarinejad Z, Farhani nezhad S, kashani S. Comparison of performance indicators in Shahid Mohammadi hospital with national standards. Journal of Modern Medical Information Sciences. 2018; 4(1): 1-8. [In Persian]
31. Ravangard R, Arab M, Zeraati H, Rashidian A, Akbarisari A, Niroomand N, et al. A study of patient length of stay in Tehran University of Medical Sciences Obstetrics and Gynecology Specialty Hospital and its associated clinical and nonclinical factors. Hakim Research Journal. 2010; 13(2): 129-36. [In Persian]
32. Ebadi Fard Azar F, Choopani A, Saberi Anari H, Mohammadi N, Arkian S, Choopani F. Comparing performance indicators of obstetric and gynecology ward with expected limits of indicators. Journal of Hospital. 2012; 11(1): 51-62. [In Persian]
33. Rahimi B, Balamji M, Rashid A, Lotfnezhad Afshr H, Zare Fazlollahi Z, Jabraeili M. Assessing performance indicators of obstetrics and gynecology ward with expected limits of indicators at Motahari University Hospital In 2013. Journal of Urmia Nursing Midwifery Faculty. 2016; 14(5): 407-16. [In Persian]
34. Jonaidi N, Sadeghi M, Izadi M, Ranjbar R. Comparison of performance indicators in one of hospitals of Tehran with national standards. Ran J Mil Med. 2011; 12(4): 223-8.
35. Yaghoubi M, Soltani Zarandi MR, Rahmati-Najarkolaei F. Factors affecting bed occupancy rate based on multiple-criteria decision analysis (hierarchical analysis) in a military hospital. Journal Mil Med. 2017;19(4): 344-50. [In Persian]
36. Toroski M, Golmakani E, Sodagar HR, Hosseini SH, Rajabzadeh R, Borhaninejad VR, et al. Survey of bed efficiency for hospitals of North Khorasan University of Medical Sciences by using standard functional criteria of the Ministry of Health. Journal of North Khorasan University of Medical Sciences. 2014; 6(3): 637-44. [ In Persian] [DOI: 10.29252/jnkums.6.3.637]
37. Xiao J, Douglas D, Lee AH, Vemuri SR. A Delphi evaluation of the factors influencing length of stay in Australian hospitals. The International Journal of Health Planning Management. 1997; 12(3): 207-18.
38. Yaghoubi M, Karimi S, ketabi S, Javadi M. Investigating the factors affecting the length of patients' stay in Alzahra Medical Center based on hierarchical analysis. Health Information Management. 2010; 2(3): 6-8. [In Persian]
39. Amiresmaili MR, Mosleh A, Isfahani P, Emami M. The effective factors in improving hospital performance indicators from the viewpoint of Zabol hospital, Iran, Managers. Journal of Health Development. 2012; 1(1): 56-66. [In Persian]
40. Arab M, Zarei A, Rahimi A, Rezaiean F, Akbari F. Analysis of factors affecting length of stay in public hospitals in Lorestan province, Iran. Hakim Research Journal. 2010; 12(4): 27-32. [In Persian]
41. Yaghoubi M, Agha Rahimi Z, Javadi M. Factors affecting in productivity index in Noor & Ali Asghar Hospital in Esfahan base on hierarchical analysis process technique. Health Inf Manage. 2013;10(4): 1-9. [In Persian]
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