Hospital's Efficiency in Iran: A Systematic Review and Meta-Analysis of Two Decades of Research

Increasing healthcare organizations’ efficiency is a necessity due to the resource scarcity in health sector. The aim of this study was to evaluate hospitals’ efficiency in Iran.
This study was conducted using a systematic review and meta-analysis approach to find empirical research papers published on hospital efficiency in Iran between 1997 and 2016. Seven electronic databases and two search engines were searched using appropriate key words. Bibliography section of the retrieved papers and related journals were also searched for papers that were not yet indexed in the data bases. 1563 publications were identified. All retrieved papers were assessed using a checklist before analysis. Finally 91 empirical studies were reviewed.
Data Envelopment Analysis, Pabon Lasso and Stochastic Frontier Analysis methods were mostly used for measuring hospital efficiency respectively. The average efficiency of Iran hospitals varied between 0.584 and 0.998. Hospitals affiliated to Social security organisation were more efficient. In contrast, non teaching public hospitals and charity and private hospitals were less efficient. Number of hospital beds and manpower were the most used input variables and number of outpatients and inpatients patient and surgical procedures were the most used output variables in Data Envelopment Analysis. Stochastic Frontier Analysis method has more advantage in measuring hospital efficiency compared to Data Envelopment Analysis.
Iran hospitals suffer from inefficiency. Thus, managers should identify the reasons for hospitals’ ineffeiciency and apply measures for increasing their efficiency and reducing wastage of limited resources.