Public and private hospital services reform using data envelopment analysis to measure technical, scale, allocative, and cost efficiencies.

BACKGROUND: The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. METHODS: This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. RESULTS: Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). CONCLUSION: In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level.

Monitoring of congenital anomalies in developing countries: a pilot model in Iran.

AIMS: This is an ongoing project aiming to establish a monitoring system of congenital anomalies in the Northwest of Iran, and to implement control and preventive tasks in the region. METHODS: Our program covers about 15 000 births (average per year) in a defined area with about 350 cases (average per year) of congenital anomalies born in the region. The definition of the congenital anomalies is based on the standard coding system of the International Classification of Diseases according to the primary diagnosis of anomaly. RESULTS: The program examines the rates and patterns of various types of congenital anomalies and looks for possible local causes and influencing factors in the population. This monitoring program provides a pilot model into the epidemiology and potential for prevention and control of congenital anomalies in the community level. Evaluation procedures are essential part of our program to monitor the effects of preventive services for congenital anomalies in order to identify and correct shortcomings. CONCLUSION: Our program provides some essential data as an epidemiological tool for local investigators, information for health service planners, clinicians and for genetic counselors. It may also help to identify regional interventions that could help to prevent and control congenital anomalies in the study population and similar areas.