Frontier-based techniques in measuring hospital efficiency in Iran: a systematic review and meta-regression analysisReportar como inadecuado

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BMC Health Services Research

, 13:312

Health systems and services in low and middle income settings


BackgroundIn 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.

MethodsPersian 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.

ResultsA 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.

ConclusionsThe 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.

KeywordsTechnical efficiency Meta-regression Data envelopment analysis Stochastic frontier analysis Iran Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-13-312 contains supplementary material, which is available to authorized users.

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Autor: Aliasghar A Kiadaliri - Mehdi Jafari - Ulf-G Gerdtham


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