Identification of the most appropriate variables for measuring the efficiency of Iranian public hospitals: Using Delphi technique

J Educ Health Promot. 2019 Jul 29:8:140. doi: 10.4103/jehp.jehp_402_18. eCollection 2019.

Abstract

Context: Selecting variables is a fundamental step in evaluating comparative efficiency because the results of measuring efficiency depend on the used variables.

Aims: The aim of this study is to provide a comprehensive set of input and output variables for measuring efficiency with an emphasis on application in general hospitals in Iran.

Materials and methods: This study comprised a literature review followed by a Delphi survey process. After extracting the variables from the literature review in order to reach consensus on them and identify the native variables, the researchers used the Delphi technique in three rounds. Thirty Iranian hospital managers, in Alborz, Saveh, Qazvin, Qom, and Hamadan universities, participated in this study. For analysis, the interquartile range (IQR) and median were used. IQR was used to assess the agreement of Delphi panel members.

Results: After literature review, nine indicators were identified as input variables and 11 indicators were identified as output variables. After the proposed changes by Delphi members, 24 input variables and 24 output variables were identified to measure hospital efficacy. Finally, ten variables were selected as inputs and ten variables were selected as outputs to measure the performance of public hospitals in Iran by using the consensus of the members in the Delphi panel.

Conclusions: This study proposes a framework for selecting the most appropriate variables for measuring the hospital efficiency with an emphasis on nonparametric methods. Choosing variables to measure hospital efficiency requires infrastructure such as an intelligent information system.

Keywords: Delphi technique; Iran; efficiency; public hospital.