ABSTRACT
Background: High hospital costs on one hand, and limited resources and facilities on the other hand, have led hospital managers to reduce costs and increase efficiency. Performance measurement is one of methods for assessing efficiency of hospital .in terms of resource utilization. Therefore, the present study was conducted with the aim of evaluating the efficiency of hospitals affiliated with Bushehr University of Medical Sciences before and after the implementation of the Health development Plan
Methods: This study is descriptive-analytic. The research population of this study was all hospitals affiliated with Bushehr University of Medical Sciences whose performance was evaluated in two years of 2013 and 2014. To measure the efficiency of these hospitals, data frontier analysis was used. The criteria of the total number of employees, the total number of physicians, the number of nurses and active beds were studied as input variables, and the percentages of cesarean section in total deliveries, number of surgeries, average residence. The data were collected in collaboration with the University's Center of Statistics as well as referring to the hospitals and analyzed using DEA software
Results: The mean technical efficiency, managerial and scale of performance before the implementation of health system development plan were reported 0.934 +/- 0.116, 1.00 +/- 0.0 and 0.934 +/- 0.116, respectively. Furthermore, six out of the eight hospitals studied were technically and scale-oriented efficient, and all eight hospitals were efficient regarding management. Only two hospitals had a surplus and two hospitals were inadequate. The mean efficiency after the implementation of the development plan was 0.9504 +/- 0.131, 0.977 +/- 0.059 and 0.966 +/- 0.088,respectively
Conclusion: According to the findings of this study, the health system development plan has had a positive effect on the efficiency of hospitals, Although the efficiency of hospitals is desirable, it is essential that managers and policymakers of the health sector take measures to improve the efficacy and increase the use of resources
ABSTRACT
Hyperhomocysteinemia is accompanied by many cardiovascular risk factors. However it's relation with other cardiac risk factors and with extent of coronary artery disease [CAD] is still a controversial issue. This study was designed to investigate the relationship between total plasma homocysteine [tHcy] levels and other cardiovascular risk factors and the severity of CAD. Fasting plasma tHcy levels were measured in 60 patients with angiographically documented CAD and compared to 56 control subjects matched for age, sex, and smoking habits. Also patients were classified into two groups of low risk [with two or few risk factor] and high risk [with three and more risk factor] according to their major risk factors. Mean of tHcy levels were significantly higher in high risk patients compared to low risk patients [p=0.013]. Also hyperhomocysteinemia rate was higher in the high risk patients compared to low risk patients, OR=5 [CI 95%=1.6-16].There was relationship between coronary risk factors and severe coronary artery disease [three vessels disease] but this relationship was statistically significant only in smokers [P=0.012] and diabetic patients [P=0.035]. Plasma tHcy level was an independent risk factor for high risk patients.