Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1392
5
1
gregorian
2013
8
1
20
110
online
1
fulltext
fa
کاربرد روش های پارامتریک در تخمین کارایی بیمارستان: مطالعه موردی بیمارستان های تحت پوشش وزارت رفاه و تامین اجتماعی
Using parametric methods in hospital efficiency measurement: a case study in hospitals affiliated to social security and welfare ministry
آمار حیاتی
Biostatistics
پژوهشي
Research
<p align="right">
<font face="Times New Roman" size="3"> </font></p><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">زمینه و هدف</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">:</span><span lang="AR-SA" style="color: black font-family: "B Mitra" font-size: 12pt"> </span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">بخش
سلامت به عنوان یکی از مهمترین بخشهای خدماتی و جزئی از شاخصهای توسعه و رفاه
اجتماعی تلقی میگردد. در میان واحدهای تشکیل دهنده این بخش نیز بیمارستانها به
عنوان بزرگترین و پرهزینهترین واحدهای عملیاتی به شمار میآیند که جهت استفاده</span><span dir="ltr"></span><span lang="AR-SA" style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr"><span dir="ltr"></span> </span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">بهینه از امکانات و منابع، ناگزیر از به کارگیری تحلیلهای
اقتصادی و عملکردی میباشند. در این مطالعه به سنجش کارایی بیمارستانهای عمومی
تحت پوشش وزارت رفاه و تامین اجتماعی پرداخته شده است.<o:p /></span></p><p align="right"><font face="Times New Roman" size="3"> </font></p><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">روش کار</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">:
مطالعه حاضر به صورت مقطعی در فاصله سالهای 1385 تا 1387 به صورت میدانی و کتابخانهای
انجام شده و به منظور سنجش کارایی با استفاده از روش تحلیل مرزی تصادفی، نرم افزار
</span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">Frontier</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> ویرایش </span><span dir="ltr"></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr"><span dir="ltr"></span>4.1</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> مود استفاده قرار گرفته است</span><span dir="ltr"></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr"><span dir="ltr"></span>.</span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><o:p /></span></p><p align="right"><font face="Times New Roman" size="3"> </font></p><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">یافته ها:</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">
یافتهها نشان میدهد که میانگین نمره کارایی بیمارستانهای تحت مطالعه برابر با
834/0 با نوسان نمره، بین 947/0 – 55/0 بوده است. ضمناً در طی هیچ یک از سالهای
مورد مطالعه، بیمارستانهای مورد بررسی نتوانستهاند به کارایی فنی کامل، (</span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">TE = 1</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>) دست یابند.<o:p /></span></p><p align="right"><font face="Times New Roman" size="3"> </font></p><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">نتیجه</span></b><b><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-size: 10.0pt" dir="ltr"></span></b><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">گیری</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">:
به نظر میرسد استفاده همزمان از تکنیکهای پارامتریک و ناپارامتریک، بهتر میتواند
به ترسیم وضعیت موجود و نشان دادن مرز کارای خدمات بیمارستانی در نظام سلامت کشور
کمک کند. مضافاً اینکه استفاده از مدیران کارآزموده و تخمین دقیق تعداد کارکنان
مورد نیاز هر بخش در کنار توجه به نتایج حاصل از تحلیلهای اقتصادی و سنجش عملکرد،
میتواند به نحو مطلوبی به استفاده هر چه بیشتر از نهادهها و ارتقای بهرهوری نظام
بیمارستانی کشور کمک کند.<o:p /></span></p><p align="right"><font face="Times New Roman" size="3"> </font></p>
<font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA">Background: </span></b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Health
Sector is considered as one of the most important service subsystems and at the
same time a segment of social security and development indices. Among this,
hospitals are mentioned as the greatest and most costly operational unit of
health sector that need to apply economical and performance analysis to access
optimal use of facilities and resources. This study is conducted to assess the
efficiency in general hospitals of Social Security Organization (SSO), Iran.</span><span style="mso-bidi-font-family: "B Mitra""><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Methods</span></b><span style="font-family: "Times New Roman","serif" font-size: 12pt">: This is a
cross sectional study that was conducted between 2006 to 2007 in the field by
applying library resources. In order to assess the efficiency with Stochastic
Frontier Analysis (SFA), Frontier version 4.1 was acquired.</span><span style="mso-bidi-font-family: "B Mitra""><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph tab-stops: right 7.3pt center 265.9pt"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Results:</span></b><span style="font-family: "Times New Roman","serif" font-size: 12pt"> Results show
that the average mean of efficiency in these hospitals was 0.834 by deviation
of 0.55 to 0.947. Furthermore in non of the studied years, these hospitals
could achieve the total technical efficiency level (TE=1).</span><span style="mso-bidi-font-family: "B Mitra""><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Conclusions: </span></b><span style="color: black font-family: "Times New Roman","serif" font-size: 12pt">It
seems that applying parametric and nonparametric techniques together can lead
to better illustration of the recent situation and present the efficient burden
of hospital services in our health sector. In addition, employing experienced
managers and evaluating the proper number of staff in each hospital parts along
with extra attention to the results of economical and performance analysis can
lead to fully employment of inputs and increase our hospitals production.</span><span style="mso-bidi-font-family: "B Mitra""><o:p /></span></p><font face="Times New Roman" size="3"> </font>
کارایی فنی، بیمارستان، تحلیل مرزی تصادفی.
Technical efficiency, Hospital, Stochastic Frontier Analysis (SFA).
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36
http://rjms.iums.ac.ir/browse.php?a_code=A-10-1-1436&slc_lang=fa&sid=1
Nahid
Hatam
ناهید
حاتم
3900319475328460023752
3900319475328460023752
Yes
Shiraz University of Medical Sciences
دانشگاه علوم پزشکی شیراز
Kimia
Pourmohammadi
کیمیا
پور محمدی
3900319475328460023753
3900319475328460023753
No
Shiraz University of Medical Sciences
دانشگاه علوم پزشکی شیراز
Peyvand
Bastani
پیوند
باستانی
3900319475328460023754
3900319475328460023754
No
Shiraz University of Medical Sciences
دانشگاه علوم پزشکی شیراز
Mehdi
Javanbakht
مهدی
جوانبخت
3900319475328460023755
3900319475328460023755
No
Shiraz University of Medical Sciences
دانشگاه علوم پزشکی شیراز