Division of Health Economics, Department of Clinical Sciences-Malmö, Lund University, Malmö University Hospital, CRC, Entrance 72, House 28, Plan 10, Room 027, 20502 Malmö, Sweden.
BMC Health Serv Res. 2013 Aug 15;13:312. doi: 10.1186/1472-6963-13-312.
In recent years, there has been growing interest in measuring the efficiency of hospitals in Iran and several studies have been conducted on the topic. The main objective of this paper was to review studies in the field of hospital efficiency and examine the estimated technical efficiency (TE) of Iranian hospitals.
Persian and English databases were searched for studies related to measuring hospital efficiency in Iran. Ordinary least squares (OLS) regression models were applied for statistical analysis. The PRISMA guidelines were followed in the search process.
A total of 43 efficiency scores from 29 studies were retrieved and used to approach the research question. Data envelopment analysis was the principal frontier efficiency method in the estimation of efficiency scores. The pooled estimate of mean TE was 0.846 (±0.134). There was a considerable variation in the efficiency scores between the different studies performed in Iran. There were no differences in efficiency scores between data envelopment analysis (DEA) and stochastic frontier analysis (SFA) techniques. The reviewed studies are generally similar and suffer from similar methodological deficiencies, such as no adjustment for case mix and quality of care differences. The results of OLS regression revealed that studies that included more variables and more heterogeneous hospitals generally reported higher TE. Larger sample size was associated with reporting lower TE.
The features of frontier-based techniques had a profound impact on the efficiency scores among Iranian hospital studies. These studies suffer from major methodological deficiencies and were of sub-optimal quality, limiting their validity and reliability. It is suggested that improving data collection and processing in Iranian hospital databases may have a substantial impact on promoting the quality of research in this field.
近年来，人们对衡量伊朗医院效率的兴趣日益浓厚，已经有几项关于该主题的研究。本文的主要目的是回顾医院效率领域的研究，并考察伊朗医院的估计技术效率（TE）。
搜索了与伊朗医院效率测量相关的波斯语和英语数据库。应用普通最小二乘法（OLS）回归模型进行统计分析。在搜索过程中遵循了 PRISMA 指南。
共检索到 29 项研究的 43 个效率得分，并用于解决研究问题。数据包络分析是估计效率得分的主要前沿效率方法。总体平均 TE 的估计值为 0.846（±0.134）。伊朗进行的不同研究之间的效率得分存在相当大的差异。DEA 和随机前沿分析（SFA）技术之间的效率得分没有差异。所审查的研究通常相似，并且存在类似的方法学缺陷，例如没有调整病例组合和护理质量差异。OLS 回归的结果表明，纳入更多变量和更多异质医院的研究通常报告更高的 TE。较大的样本量与报告较低的 TE 相关。
基于前沿的技术特征对伊朗医院研究的效率得分产生了深远的影响。这些研究存在主要的方法学缺陷，且质量欠佳，限制了其有效性和可靠性。建议改善伊朗医院数据库的数据收集和处理，可能会对提高该领域研究质量产生重大影响。
