Applications of Data Envelope Analysis Using Efficient or Inefficient Frontiers in Evaluating the Efficiency of Rural Healthcare Centers (Case Study: Langroud County)

Document Type : علمی

Authors

1 University of Guilan

2 Guilan Medical Sciences University

3 University of Guilan.

Abstract

Objective: This study was conducted to examine the efficiency of rural healthcare centers (Health Houses) including output-oriented efficiency, input-oriented efficiency, optimistic efficiency, pessimistic efficiency and efficiency range in Langerud County in Guilan province.
Method: This study is a descriptive-analytical one whose data is cross-sectional collected through field works in 2016 from 45 rural healthcare centers in Langerud County. The required data were obtained from available documents and statistics, and were analyzed using Windeap and GAMS software packages. In this paper, to evaluate the performance of rural healthcare centers from March 2015 to March 2016, two inputs and three outputs were determined. The input included the costs and the number of health workers, and the outputs included family health clients, outpatients, and the clients who needed wound dressings.
Findings: The results showed that nine out of 45 rural healthcare centers, with an efficiency score of 1, have efficient performance. Rural healthcare centers in villages of Garask, Koru Roud Khaneh, and Malat are respectively the first three villages with the highest efficiency score. The study results showed that the average optimistic efficiency at output-oriented and input-oriented efficiencies are 1.645 and 0.688, respectively, and 15.5% of rural healthcare centers are pessimistically inefficient. Besides, 64% of the units are between the efficient and inefficient frontiers, and are not pessimistically inefficient; meanwhile, those units are not on pessimistic lines of efficiency which demonstrates indulgence in input consumption or a potential ability in increased offered services or decreased input consumption. According to the results, maximum optimistic efficiency is 3.87 and its minimum is one. Maximum pessimistic efficiency is one and its minimum is 0.29.
Practical Implications: As the results show, it is suggested that efficient healthcare units be used as paragons and that assessing educational requirements of inefficient rural healthcare centers would provide useful information for planners and policy makers.

Keywords

References

1. Abolhallaji, M., Mousavi, S. M., Anjomshoa, M., Nasiri, A.B., Seyedin, H., & Sadeghifar, J. (2014). Assessing health inequalities in Iran: A focus on the distribution of health care facilities. Global Journal of Health Science, 6(4), 285-295.
2. Alin, O., & Marieta, M. (2011). Determining the efficiency of health expenditure as a prerequisite for achieving economic equilibrium in the European Union. Economics and Finance Research, 4, 81-85.
3. Ancarani, A., Mauro, D., & Giammanco, M. D. (2009). The impact of managerial and organizational aspects on hospital wards’ efficiency: Evidence from a case study. European Journal of Operational Research, 194, 280-293.
4. Asaee, A. (1380/2001). Health and environment in sustainable development. Ministry of Health and Medical Education Press. [In Persian]
5. Azizi, H., & Jahed, R. (2011). Improved data envelopment analysis models for evaluating interval efficiencies of decision-making units. Computers & Industrial Engineering, 61(3), 897-901. ‏
6. Azizi, H., & Wang, Y. M. (2013). Improved DEA models for measuring interval efficiencies of decision-making units. Measurement, 46(3), 1325-1332. ‏
7. Bagherzadeh, A. (1389/2010). New concepts in agricultural economics. Urmia: SID Publications. [In Persian]
8. Charnes, A., Cooper, W. W., & Rhodes, E. (1978). Measuring the Efficiency of Decision Making Units. European Journal of Operational Research, 1(2), 429-444.
9. Emami Meibodi, A. (1379/2000). Efficiency and productivity measurement: In theory and practice. Institute for trade studies and research press, Tehran, Iran. [In Persian]
10. Farrell, M. J. (1957). The measurement of productive efficiency. Journal of the Royal Statistical Society. Series A (General), 120(3), 253-290. ‏
11. Fortuna, T., & Cardillo, D. D. L. (2000). A DEA model for the efficiency evaluation of nondominated paths on a road network. European Journal of Operational Research, 121(3), 549-558. ‏
12. Hosseini Nike, A. (1378/1999). Constitution of the Islamic Republic of Iran. Tehran: Majd Scientific and Cultural Assembly Press. [In Persian]
13. Iran's Economic Reports. (1383/2004). Management and planning organization press. Tehran, Iran. p. 434. [In Persian]
14. Kermani, A. (1388/2009). The efficiency of Islamic countries in the health and education sectors using Data Envelopment Analysis (DEA). Journal of Sustainable Development, 37, 65-88. [In Persian]
15. Leleu, H., & Moises, J. (2014). How do payer mix and technical inefficiency affect hospital profit? Operations Research for Health Care, 3(4), 231-237.
16. Mahmudifar, Y. (1386/2007). Health service delivery systems in the world and Iran. Journal of Health Homay, 19, 23-33. [In Persian]
17. Marschall, P., & Flessa, S. (2008). Assessing the efficiency of rural health centers in Burkina Faso: An application of Data Envelopment Analysis. Journal of Public Health, 17, 87–95.
18. Mastaneh, Z., & Mouseli, L. (2011). Health information position in new reform of American healthcare system. Information Management Journal, 8(1), 97-101.
19. Mehregan, M. R. (1383/2004). Quantitative models in evaluating the performance of organizations. Tehran: Tehran University Press. [In Persian]
20. Mehregan, M. R. (1387/2008). Quantitative performance evaluation model in organizations. Tehran: Tehran University Press. [In Persian]
21. Moazeni, S., & Karbasi, A. (1387/2008). Measuring different efficiencies with data envelopment analysis. Case study: Pistachio producers in Zarand. Agricultural Economics and Development, 61, 1-16. [In Persian]
22. Mohammadi, M., Karami, B., Bayat, R., Esfandnia, F., Kazemi, N., Bayati, M., Esfandnia, A. (2015). Assessment of technical efficiency of university hospitals in Kermanshah model using data envelopment analysis (DEA). Technical Journal of Engineering and Applied Sciences, 5(1), 80-83.
23. Mojarrad, E., Kaikha, A. A., & Sabuhi-Sabuni, M. (1388/2009). Evaluating technical efficiency of agriculture units by stochastic nonparametric approach in the Sistan zone. Agricultural Economics, 3(3), 91-106. [In Persian]
24. Najarzadeh, M., Torabipoor, A., Ghasemzadeh, R., & Salehi, R. (2012). Assessment of hospitals’ efficiency through Data Envelopment Analysis in Ahvaz in 2006-2010. Jundishapur Journal of Health Sciences, 4(3), 77–87.
25. Nastaran, M. (1380/2001). Analysis and measuring degree of concentration and distribution of health indices in Isfahan. Journal of Faculty of Humanities (Isfahan University), 10(2), 145-162. [In Persian]
26. Nattinger, M. C., Mueller, K., Ullrich, F., & Zhu, X. (2016). Financial performance of rural medicare ACOs. The Journal of Rural Health, 60, 1-9.
27. Nikeniyaz, A. R. (1382/2003). Healthy environments support health and sustainable development. Tehran, Iran: Sotoudeh Press. [In Persian]
28. Parsay, S. (1382/2003). Public health. Tehran: Hygiene Press. [In Persian]
29. Sadeghi Bazargani, H., Arshi, S., Mortezazadeh, A., Bashiri, J., AminiSani, N., & Sezavar, H. (2005). The study of indicators of tribes of Ardebil’s health status. Ardabil University of Medical Sciences Journal, 5(2), 150-159.
30. Shojja, N., Abri, A. G., & Khalili, N. (1393/2014). Firoozkooh city health house performance evaluation using data envelopment analysis. Journal of Economic Modeling, 27, 53-69. [In Persian]
31. Taban, H., Zamani, A., & Sadeghi, B. (1380/2001). Evaluation of mental health program in healthcare homes of Isfahan province. Research in Medical Sciences, 7(2), 108-122. [In Persian]
32. Thanaan, R., Chulaporn, L., & Supon, L. (2008). Assessing the efficiency of hospital pharmacy services in Thai public district hospitals. Southeast Asian Journal of Tropical Medicine and Public Health, 39(4), 753-765.
33. The World Health Report. (WHO) (2000). Health systems, improving performance. Geneva: World Health Organization Press.
34. Tolouei, A. (1390/2011). Measuring the efficiency of Iran Air Company. Financial Engineering and Management of Securities, 7(2), 97-120. [In Persian]
35. Tourani, S., & Hatam, N. (1384/2005). Application of multiple attribute decision making models to measure hospital efficiency. The Journal of Qazvin University of Medical Sciences, 9(4), 87-93. [In Persian]
36. Tourani, S., Tabibi, S.J., Tofoghi, S., & Shaarbafchi, Z. (1390/2011). International trade in health services in the selected countries of ASEAN region: Challenges and opportunities. Health Information Management Journal, 8(4), 453- 468. [In Persian]
37. Wang, Y. M., & Chin, K. S. (2009). A new approach for the selection of advanced manufacturing technologies: DEA with double frontiers. International Journal of Production Research, 47(23), 6663-6679. ‏
38. Zareai, B. (1379/2000). Designing performance measures in health institutions. (Unpublished master's thesis), Tehran University, Tehran. [In Persian]
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Journal of Research and Rural Planning
Volume 6, Issue 3 - Serial Number 19
November 2017
Pages 203-216

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  • Receive Date: 06 February 2017
  • Accept Date: 06 February 2017

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