Hospital Efficiency Measurement in the West of Iran: Data Envelopment Analysis and Tobit Approach

Objective The optimal hospital performance and optimal use of resources are among the goals of healthcare policymakers. This study aimed to assess the association between hospital size and hospital area population with technical efficiency in public hospitals . Methods In this descriptive-analytical study, the statistical population consisted of 15 public hospitals in the west of Iran. First, the data envelopment analysis (DEA) method was used to evaluate technical efficiency. Data inputs included staff and beds, and data outputs consisted of the number of surgeries, the number of patients, and the average length of stay. Then, according to the public ownership of all hospitals, their educational and therapeutic activities, as well as their size and population were considered as the environmental factor affecting efficiency. Thus, Tobit regression was applied to measure their effects on efficiency. Results The average technical efficiency of the studied hospitals, the average management efficiency, and the average efficiency of the scale were 0.933, 0.951, and 0.977, respectively. Out of the total evaluated hospitals, six and nine hospitals had an efficiency of less than one and one, respectively. Moreover, the size of the hospital and the population as the environment variable were significant in the Tobit model. Our regression demonstrated that although the size of the hospital is positively associated with its technical efficiency, the hospital population negatively affects hospital efficiency. Conclusion According to the size and area population of the hospitals, they decrease their inputs to maximize their efficacy by optimizing their surplus amounts. It would be possible for policy-makers to examine the least efficient hospitals to correct widespread inefficiency.