Comparison of the technical efficiency of the hospital sector: Panel data analysis of the Iranian hospitals using parametric and non-parametric approaches

Abstract

Background: Health system of Iran is an integrated one in a way that health care delivery and medical education are under the supervision of the Universities affiliated Medical Sciences (UMS). HSTP is a nationwide plan implemented by MHME at the hospital affiliated universities of medical science in line with achieving universal health coverage since May 5,2014. Aim: The study aimed to investigate productivity and efficiency linked to the hospitals affiliated Boshehr province before and after the implementation of the HSTP. Method: This was a descriptive-analytical study conducted by applying panel data for a 5-year time horizon. The study was carried out on eight teaching and non-teaching hospitals of Boshehr Province. An input-oriented DEA technique combined with SFA and Malmquist indices were used to estimate the efficiency and productivity changes. Data were analyzed using Excel.22 and DEA-solver learning version 8 Software. Result: It illustrated that efficiency and technological changes over the study span were -3 and +17, respectively. As a result, the Malmquist index has experienced an ongoing trend equaling +14. In spite of being a progressive trend in technical efficiency based on SFA model, the technical efficiency of the hospitals examined was not favorable. Conclusion: Estimates on the basis of the Malmquist index revealed that a 5-year average productivity change was +14. However, the implementation of health system transformation plan (HSTP) has no statistically significant effect on that. So, there is considerable room for improving technical efficiency or cost containment by way of employing unused capacity or expanding outputs.