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伊朗医疗转型计划对医院绩效的影响:克尔曼省。

The effect of Iran's health transformation plan on hospital performance: Kerman province.

机构信息

Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Somayeh Noori Hekmat, Management and Leadership in Medical Education Research Center, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

PLoS One. 2021 Feb 17;16(2):e0247155. doi: 10.1371/journal.pone.0247155. eCollection 2021.

Abstract

Iran has performed Health Transformation Plan (HTP) from 2014 to obtain its defined goals. This study assesses and compares university and non-university hospitals' efficiency and productivity in Kerman provinces, Iran. The data of 19 selected hospitals, two years before and two years after Health Transformation Plan, was collected in this cross-sectional study. These data included the variables of physician and nurse number, and active beds as inputs and bed occupancy rate and inpatient admission adjusted with the length of stay as outputs. Data Envelopment Analysis method used to measure hospital efficiency. Malmquist Productivity Index is used to measure the efficiency change model before and after the plan. The efficiency and effect of the plan on hospitals' efficiency and productivity were assessed using R software. The results indicated that all hospitals' average efficiency before the HTP was 0.843 and after the HTP was increased to 0.874. However, it was not significant (P>0.05). Productivity also had a decreasing trend. Based on the DEA method results, it was found that university and non-university hospitals' efficiency and productivity did not increase significantly after the HTP. Therefore, it is recommended that attention be paid to hospitals' performance indicators regarding how resources are allocated and decisions made.

摘要

伊朗自 2014 年以来一直在实施卫生转型计划(HTP),以实现其既定目标。本研究评估和比较了伊朗克尔曼省大学医院和非大学医院的效率和生产力。这项横断面研究收集了 19 家选定医院在 HTP 实施前两年和后两年的数据。这些数据包括医生和护士人数以及活跃床位等投入变量,以及床位占用率和住院病人入院人数与住院时间调整后的产出变量。采用数据包络分析方法来衡量医院的效率。使用 Malmquist 生产力指数来衡量计划前后的效率变化模型。使用 R 软件评估了该计划对医院效率和生产力的影响。结果表明,所有医院在 HTP 实施前的平均效率为 0.843,而在 HTP 实施后提高到了 0.874。然而,这并不显著(P>0.05)。生产力也呈下降趋势。根据 DEA 方法的结果,发现 HTP 后大学医院和非大学医院的效率和生产力并没有显著提高。因此,建议关注医院的绩效指标,包括资源配置和决策制定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6e4/7888626/3406299855da/pone.0247155.g001.jpg

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