Evaluating the Trend of Efficiency at Inpatient Services by Pabon-Lasso Model: A Case Study in a Specialized Hospital

Document Type : Original Research

Authors

Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

Abstract

Background and Aim: Lack of attention to hospital efficiency, in addition to increasing medical costs, limits public access to health care. The purpose of this study was to draw a picture of the resource efficiency status of inpatient units and its changes over the years 2015 to 2018 in a large specialized hospital in Tehran, Iran.
Methods: This is a multiple cross-sectional and applied study. The efficiency of inpatient services was evaluated using the Pabon Lasso model in four periods (2015-2018). The study population consisted of all hospitalized units (36 inpatient units) that all were studied. In this study, hospital performance indicators were collected using a data collection form. Excel 2019 software was used to draw Pabon Lasso charts.
Results: On average, in 4 years, only 24% of inpatient units were fully efficient. Over the 4-year period, there were positive changes in the efficacy of internal gynecology, obstetrics, men general surgery, and NICU1. In addition, the efficacy of vascular and thoracic surgery, kidney transplant, NICU2 and VIP1 units had declined over the study period. There was no change in the efficiency status of the other units (27 units).
Conclusion: Many of the hospital units are far from the optimal performance point. Given the sporadic movement of hospital units towards efficiency, it is necessary to study separately the causes of positive and negative efficiency changes in each hospital unit. In this context, the use of the Pabon Lasso model is suggested monitoring changes in the efficiency of inpatient units.

Keywords

References

1. Teymourzadeh E, Bahadori M, Meskarpour-Amiri M, Khoshmanzar J, Hosseini-Shokouh S-M. Economic Performance Analysis of Selected Military Hospitals Using Hospital Indicators and Inpatient Bed-Day Cost. Hospital Practices and Research. 2019;4(1):31-8. doi:10.15171/hpr.2019.05 2. Amerioun A, Sh T, Mahdavi S, Mamaghani H, Meskarpour Amiri M. Assessment of International Joint Commission (IJC) accreditation standard in a military hospital laboratory. J Mil Med. 2011;13(2): 75-80. 3. Rezapour A, Khalaj M. The economic behavior of general hospitals of Iran University of Medical Sciences from 1997 to 2004. 2006. 4. Harrison JP, Coppola MN, Wakefield M. Efficiency of federal hospitals in the United States. Journal of Medical Systems. 2004;28(5):411-22. doi:10.1023/B:JOMS.0000041168.28200.8c 5. Osei D, d'Almeida S, George MO, Kirigia JM, Mensah AO, Kainyu LH. Technical efficiency of public district hospitals and health centres in Ghana: a pilot study. Cost Effectiveness and Resource Allocation. 2005;3(1):9. doi:10.1186/1478-7547-3-9 6. Kirigia JM, Emrouznejad A, Sambo LG. Measurement of technical efficiency of public hospitals in Kenya: using data envelopment analysis. Journal of medical systems. 2002;26(1):39-45. doi:10.1023/A:1013090804067 7. Helmig B, Lapsley I. On the efficiency of public, welfare and private hospitals in Germany over time: a sectoral data envelopment analysis study. Health Services Management Research. 2001;14(4):263-74. doi:10.1177/095148480101400406 8. Silvester KM, Mohammed MA, Harriman P, Girolami A, Downes TW. Timely care for frail older people referred to hospital improves efficiency and reduces mortality without the need for extra resources. Age and ageing. 2013;43(4):472-7. doi:10.1093/ageing/aft170 9. Kaboli PJ, Go JT, Hockenberry J, Glasgow JM, Johnson SR, Rosenthal GE, et al. Associations between reduced hospital length of stay and 30-day readmission rate and mortality: 14-year experience in 129 Veterans Affairs hospitals. Annals of internal medicine. 2012;157(12):837-45. doi:10.7326/0003-4819-157-12-201212180-00003 10. Deily ME, McKay NL. Cost inefficiency and mortality rates in Florida hospitals. Health economics. 2006;15(4):419-31. doi:10.1002/hec.1078 11. Chisholm D, Evans DB. Improving health system efficiency as a means of moving towards universal coverage. World health report. 2010:10-2. 12. Amiri MM, Tavana AM. Successful implementation of general health policies in the Islamic Republic of Iran: barriers and mechanisms. Eastern Mediterranean Health Journal. 2018;24(12): 1127-34. doi:10.26719/emhj.18.009 13. Erfani Khanghahi M, Ebadi Fard Azar F. Hospital Efficiency Using Pabon Lasso Model: A Systematic Review and Meta-Analysis. Journal of Hospital. 2018;17(2):21-32. 14. Rezaei S, Hajizadeh M, Nouri B, Ahmadi S, Rezaeian S, Salimi Y, et al. Iranian hospital efficiency: a systematic review and meta-analysis. International journal of health care quality assurance. 2019;32(2):385-97. doi:10.1108/IJHCQA-03-2018-0067 15. Kalhor R, Amini S, Sokhanvar M, Lotfi F, Sharifi M, Kakemam E. Factors affecting the technical efficiency of general hospitals in Iran: data envelopment analysis. Journal of the Egyptian Public Health Association. 2016;91(1):20-5. doi:10.1097/01.EPX.0000480717.13696.3c 16. Hosseini-Shokouh S-M, Moeini Matin H, Yaghoubi M, Sepandi M, Ameryoun A, Hosseini-Shokouh S-J. Amount and Causes of Insurance Deductions for the Armed Forces Medical Services Organization in a Military Hospital in Tehran, Iran. Journal of Military Medicine. 2018;20(4): 402-11. 17. Shepard DS, Hodgkin D, Anthony YE. Analysis of hospital costs: a manual for managers: World Health Organization; 2000. 18. Moradi G, Piroozi B, Safari H, Nasab NE, Bolbanabad AM, Yari A. Assessment of the efficiency of hospitals before and after the implementation of health sector evolution plan in Iran based on Pabon Lasso model. Iranian journal of public health. 2017;46(3):389. 19. 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. doi:10.3126/ajms.v7i6.15408 20. Mohammadkarim B, Jamil S, Pejman H, Seyyed MH, Mostafa N. Combining multiple indicators to assess hospital performance in Iran using the Pabon Lasso Model. The Australasian medical journal. 2011;4(4):175. doi:10.4066/AMJ.2011.620 21. 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. 2009:119-24. 22. Amerioun A. A, Hosseini Shokouh S. M., Karimi Zarchi A. A, Mahmoudi N. Hospital manager's leadership style from staff’s viewpoint and its relationship with hospital indicators. Journal of Military Medicine. 2011;13(3):125-32. 23. Jonaidi N, Sadeghi M, Izadi M, Ranjbar R. Comparison of performance indicators in one of hospitals of Tehran with national standards. Iran J Mil Med. 2011;12(4):223-8. 24. Mosadeghrad AM, Esfahani P, Nikafshar M. Hospitals' efficiency in Iran: A systematic review and meta-analysis of two decades of research. Journal of Payavard Salamat. 2017; 11(3):318-31. 25. Pabon Lasso H. Evaluating hospital performance through simultaneous application of several indicators. 1986. 26. Masoumi G, Hoseini Kasnaviyeh M, Tahrizadeh A, Panahi M, Najafi E. Hospital performance based on pabon lasso model. International Journal of Hospital Research. 2014;3(1):49-54. 27. Hosseini-Shokouh S-M, Sadeghian K, Ameryoun A, Zaboli R. Organizational Factors Affecting a Patient's Average Length of Stay in Hospital: Systematic Review. Journal of Military Medicine. 2019;20(6):577-88. eng. 28. Ghorbani Nia R, Ahmadian K, Ranjbar Z. To compare the performance indexes of selected hospital with national standards. JHPM. 2017;6(5):1-7. doi:10.21859/jhpm-07031 29. Toroski M, Golmakani E, Sodagar H, Hosseini S, Rajabzadeh R, Borhaninejad V, et al. Survey 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):637-4. doi:10.29252/jnkums.6.3.637 30. Reisi-Nafchy M, Drees F, Mirzaeian R. Assessment of performance indicators in Hospitals University of Medical Sciences based on the standards of the Ministry of Health. Journal of Shahrekord University of medical sciences. 2014;15(6):60-7. 31. Emamrezaei A, Barouni M. Efficiency analysis of hospitals in Iran: A systematic review. Payesh. 2017;11(3): 318-31. 32. Ebrahimi P, Bayat S, Abutorabi A. Efficiency assessment of operating rooms of teaching hospitals of Shiraz University of Medical Sciences, using data envelopment analysis: 2012-2014. Journal of Health Administration (JHA). 2018;21(72).
Journal of Military Medicine
Volume 22, Issue 9 - Serial Number 94
November and December 2020
Pages 936-946

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