Technical Efficiency in Public Hospitals: A Meta-Regression Analysis
Yıl 2022,
Cilt: 17 Sayı: 3, 810 - 821, 01.12.2022
Neylan Kaya
,
Aydolu Algın
Öz
This study attempts to examine the studies using Data Envelopment Analysis to calculate the efficiency of public hospitals and to identify the factors influencing their technical efficiency through meta-regression analysis. This study employed 35 empirical articles which were published between 1960 and 2022 and which met the inclusion criteria. The results of the meta-regression analysis revealed that the publication year of the studies and the income groups of the countries did not have an impact on the average technical efficiency. The number of hospitals, the number of variables, the year of data collection, and the continent of the countries was noted to be statistically significant in terms of the average technical efficiency estimation. This study suggested that the efficiencies of the vast majority of public hospitals were above optimal. The study is expected to raise politicians’ and administrators’ awareness of increasing the efficiency of hospitals.
Kaynakça
- Ahmadkiadaliri, A., Haghparast-Bidgoli, H., & Zarei, A. (2011). Measuring efficiency of general hospitals in the south of Iran [Article]. World Applied Sciences Journal, 13(6), 1310-1316. https://www.scopus.com/inward/record.uri?eid=2-s2.0-84861937765&partnerID=40&md5=177bdc5ee64fc9a9284a05171d09848a
- Ahmed, S., Hasan, M. Z., Laokri, S., Jannat, Z., Ahmed, M. W., Dorin, F., Vargas, V., & Khan, J. A. M. (2019). Technical efficiency of public district hospitals in bangladesh: A data envelopment analysis [Article]. Cost Effectiveness and Resource Allocation, 17(1), 1-10, Article 15. https://doi.org/10.1186/s12962-019-0183-6
- Alatawi, A., Ahmed, S., Niessen, L., & Khan, J. (2019). Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings. Cost Eff Resour Alloc, 17, 17. https://doi.org/10.1186/s12962-019-0185-4
- Alatawi, A. D., Niessen, L. W., & Khan, J. A. M. (2020). Efficiency evaluation of public hospitals in Saudi Arabia: An application of data envelopment analysis [Article]. BMJ Open, 10(1), Article e031924. https://doi.org/10.1136/bmjopen-2019-031924
- Applanaidu, S. D., Samsudin, S., Ali, J., Dash, U., & Chik, A. R. (2014). Technical and Scale Efficiency of Public District Hospitals in Kedah, Malaysia: A Data Envelopment Analysis (DEA) [Article]. Journal of Health Management, 16(3), 327-335. https://doi.org/10.1177/0972063414539595
- Asiabar, A. S., Sharifi, T., Rezapour, A., Khatami Firouzabadi, S. M. A., Haghighat-Fard, P., & Mohammad-pour, S. (2020). Technical efficiency and its affecting factors in Tehran’s public hospitals: DEA approach and Tobit regression [Article]. Medical Journal of the Islamic Republic of Iran, 34, 1-9. https://doi.org/10.34171/mjiri.34.176
- Blatnik, P., Bojnec, Š., & Tušak, M. (2017). Measuring efficiency of secondary healthcare providers in Slovenia. Open Medicine, 12(1), 214-225. https://doi.org/10.1515/med-2017-0031
- Chang, H.-H. (1998). Determinants of Hospital Efficiency: the Case of Central Government-owned Hospitals in Taiwan. Omega, 26(2), 307-317. https://doi.org/10.1016/s0305-0483(98)00014-0
- Chang, H., Cheng, M.-A., & Das, S. (2004). Hospital ownership and operating efficiency: Evidence from Taiwan. European Journal of Operational Research, 159(2), 513-527. https://doi.org/10.1016/s0377-2217(03)00412-0
- Cheng, Z. H., Tao, H. B., Cai, M., Lin, H. F., Lin, X. J., Shu, Q., & Zhang, R. N. (2015). Technical efficiency and productivity of Chinese county hospitals: an exploratory study in Henan province, China [Article]. Bmj Open, 5(9), 10, Article e007267. https://doi.org/10.1136/bmjopen-2014-007267
- Cordero, J. M., García‐García, A., Lau‐Cortés, E., & Polo, C. (2021). Assessing Panamanian hospitals' performance with alternative frontier methods. International Transactions in Operational Research. https://doi.org/10.1111/itor.13013
- Dash, U., Vaishnavi, S. D., Muraleedharan, V. R., & Acharya, D. (2007). Benchmarking the Performance of Public Hospitals in Tamil Nadu. Journal of Health Management, 9(1), 59-74. https://doi.org/10.1177/097206340700900104
- Farrell, M. J. (1957). The Measurement of Productive Efficiency. Journal of the Royal Statistical Society: Series A (General), 120(3), 253-281. https://doi.org/https://doi.org/10.2307/2343100
- Flokou, A., Kontodimopoulos, N., & Niakas, D. (2011). Employing post-DEA Cross-evaluation and Cluster Analysis in a Sample of Greek NHS Hospitals [Article]. Journal of Medical Systems, 35(5), 1001-1014. https://doi.org/10.1007/s10916-010-9533-9
- Fragkiadakis, G., Doumpos, M., Zopounidis, C., & Germain, C. (2016). Operational and economic efficiency analysis of public hospitals in Greece [Article]. Annals of Operations Research, 247(2), 787-806. https://doi.org/10.1007/s10479-014-1710-7
- Giancotti, M., Rotundo, G., Pipitone, V., & Mauro, M. (2018). Efficiency and Optimal size of Italian Public Hospitals: Results from Data Envelopment Analysis [Article]. Epidemiology Biostatistics and Public Health, 15(4), 12, Article e12929. https://doi.org/10.2427/12929
- Gok, M. S., & Altındağ, E. (2015). Analysis of the cost and efficiency relationship: experience in the Turkish pay for performance system. The European Journal of Health Economics, 16(5), 459-469. https://doi.org/10.1007/s10198-014-0584-6
- Haghdoost, A. A., & Moosazadeh, M. (2013). The prevalence of cigarette smoking among students of Iran's universities: A systematic review and meta-analysis. J Res Med Sci, 18(8), 717-725. https://www.ncbi.nlm.nih.gov/pubmed/24379851
- Helal, S. M. A., & Elimam, H. A. (2017). Measuring the Efficiency of Health Services Areas in Kingdom of Saudi Arabia Using Data Envelopment Analysis (DEA): A Comparative Study between the Years 2014 and 2006. International Journal of Economics and Finance, 9(4), 172. https://doi.org/10.5539/ijef.v9n4p172
- Hollingsworth, B., Dawson, P., & Maniadakis, N. (1999). Efficiency Measurement of Health Care: A Review of Non-Parametric Methods and Applications. Health care management science, 2, 161-172. https://doi.org/10.1023/A:1019087828488
- Jat, T. R., & Sebastian, M. S. (2013). Technical efficiency of public district hospitals in Madhya Pradesh, India: a data envelopment analysis [Article]. Global Health Action, 6, 1-8. https://doi.org/10.3402/gha.v6i0.21742
- Kakeman, E., Rahimi Forushani, A., & Dargahi, H. (2016). Technical Efficiency of Hospitals in Tehran, Iran [Article]. Iranian Journal of Public Health, 45(4), 494-502. <Go to ISI>://WOS:000376045100010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888177/pdf/IJPH-45-494.pdf
- Kiadaliri, A. A., Jafari, M., & Gerdtham, U.-G. (2013). Frontier-based techniques in measuring hospital efficiency in Iran: a systematic review and meta-regression analysis. BMC Health Services Research, 13(1), 312. https://doi.org/10.1186/1472-6963-13-312
- Kiani, M., Raei, B., Asbagharani, P., Yousefi, M., Rigi, S., Salehi, M., & Shiraz, S. (2018). Comparison of the technical efficiency of the hospital sector: Panel data analysis of the Iranian hospitals using parametric and non-parametric approaches. Bali Medical Journal, 8, 114. https://doi.org/10.15562/bmj.v8i1.1242
- Kirigia, J. M., Emrouznejad, A., Cassoma, B., Asbu, E. Z., & Barry, S. (2008). A Performance Assessment Method for Hospitals: The Case of Municipal Hospitals in Angola. Journal of Medical Systems, 32(6), 509-519. https://doi.org/10.1007/s10916-008-9157-5
- Kounetas, K., & Papathanassopoulos, F. (2013). How efficient are Greek hospitals? A case study using a double bootstrap DEA approach [Article]. European Journal of Health Economics, 14(6), 979-994. https://doi.org/10.1007/s10198-012-0446-z
- Kuntz, L., Scholtes, S., & Vera, A. (2007). Incorporating efficiency in hospital-capacity planning in Germany. The European Journal of Health Economics, 8(3), 213-223. https://doi.org/10.1007/s10198-006-0021-6
- Li, N. N., Wang, C. H., Ni, H., & Wang, H. (2017). Efficiency and Productivity of County-level Public Hospitals Based on the Data Envelopment Analysis Model and Malmquist Index in Anhui, China [Article]. Chinese Medical Journal, 130(23), 2836-2843. https://doi.org/10.4103/0366-6999.219148
- Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Group, P. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol, 62(10), 1006-1012. https://doi.org/10.1016/j.jclinepi.2009.06.005
- Moosazadeh, M., Nekoei-Moghadam, M., Emrani, Z., & Amiresmaili, M. (2014). Prevalence of unwanted pregnancy in Iran: a systematic review and meta-analysis. Int J Health Plann Manage, 29(3), e277-290. https://doi.org/10.1002/hpm.2184
- O’Neill, L., Rauner, M., Heidenberger, K., & Kraus, M. (2008). A cross-national comparison and taxonomy of DEA-based hospital efficiency studies. Socio-Economic Planning Sciences, 42(3), 158-189. https://doi.org/10.1016/j.seps.2007.03.001
- Osei, D., D'Almeida, S., George, M. O., Kirigia, J. M., Mensah, A. O., & Kainyu, L. H. (2005). Technical efficiency of public district hospitals and health centres in Ghana: a pilot study. Cost Effectiveness and Resource Allocation, 3(1), 9. https://doi.org/10.1186/1478-7547-3-9
- Pham, T. L. (2011). Efficiency and productivity of hospitals in Vietnam [Article]. Journal of Health, Organisation and Management, 25(2), 195-213. https://doi.org/10.1108/14777261111134428
- Polyzos, N. (2012). A three-year Performance Evaluation of the NHS Hospitals in Greece [Article]. Hippokratia, 16(4), 350-355. <Go to ISI>://WOS:000320844300012
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3738611/pdf/hippokratia-16-350.pdf
- Puenpatom, R. A., & Rosenman, R. (2008). Efficiency of Thai provincial public hospitals during the introduction of universal health coverage using capitation. Health care management science, 11(4), 319-338. https://doi.org/10.1007/s10729-008-9057-8
- Ramanathan, R. (2005). Operations assessment of hospitals in the Sultanate of Oman. International Journal of Operations & Production Management, 25(1), 39-54. https://doi.org/10.1108/01443570510572231
- Rezaei, S., Hajizadeh, M., Nouri, B., Ahmadi, S., Rezaeian, S., Salimi, Y., & Karyani, A. K. (2019). Iranian hospital efficiency: a systematic review and meta-analysis. Int J Health Care Qual Assur, 32(2), 385-397. https://doi.org/10.1108/IJHCQA-03-2018-0067
- Rezaei, S., Hajizadeh, M., Zandian, H., Fathi, A., & Nouri, B. (2017). Period Prevalence and Reporting Rate of Needlestick Injuries to Nurses in Iran: A Systematic Review and Meta-Analysis. Res Nurs Health, 40(4), 311-322. https://doi.org/10.1002/nur.21801
- Sendek, S. (2014). Efficiency evaluation of hospitals in the environment of the Slovak Republic [Article]. Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis, 62(4), 697-706. https://doi.org/10.11118/actaun201462040697
- Shone, R. (1981). Applications in intermediate microeconomics.
- Simoes, P., & Marques, R. C. (2011). Performance and congestion analysis of the portuguese hospital services [Article]. Central European Journal of Operations Research, 19(1), 39-63. https://doi.org/10.1007/s10100-009-0122-2
- Sultan, W. I. M., & Crispim, J. (2018). Measuring the efficiency of Palestinian public hospitals during 2010-2015: an application of a two-stage DEA method [Article]. BMC Health Services Research, 18, 17, Article 381. https://doi.org/10.1186/s12913-018-3228-1
- Yeşilyurt, M. E., Şahin, E., Elbi, M. D., Kızılkaya, A., Koyuncuoğlu, M. U., & Akbaş-Yeşilyurt, F. (2021). A novel method for computing single output for DEA with application in hospital efficiency. Socio-Economic Planning Sciences, 76, 100995. https://doi.org/10.1016/j.seps.2020.100995
- Zheng, W. H., Sun, H., Zhang, P. L., Zhou, G. J., Jin, Q. Y., & Lu, X. Q. (2018). A four-stage DEA-based efficiency evaluation of public hospitals in China after the implementation of new medical reforms [Article]. Plos One, 13(10), 17, Article e0203780. https://doi.org/10.1371/journal.pone.0203780
Kamu Hastanelerinde Teknik Etkinlik: Bir Meta-Regresyon Analizi
Yıl 2022,
Cilt: 17 Sayı: 3, 810 - 821, 01.12.2022
Neylan Kaya
,
Aydolu Algın
Öz
Bu çalışmanın amacı, kamu hastanelerinin etkinliğinin hesaplanmasında Veri Zarflama Analizini kullanan çalışmaları incelemek ve teknik etkinliklerini etkileyen faktörleri meta-regresyon analizi ile belirlemektir. 1998-2021 yılları arasında yayımlanmış ve dahil etme kriterlerini sağlayan 30 ampirik makale bu çalışmanın örneklemini oluşturmaktadır. Meta-regresyon analizi sonuçlarına göre çalışmaların yayın yılı ve ülkelerin gelir grupları ortalama teknik etkinliği etkilememektedir. Hastane sayısı, değişken sayısı, veri toplama yılı ve ülkenin bulunduğu kıta değişkenleri ortalama teknik etkinlik tahmini üzerinde istatistiksel olarak anlamlıdır. Çalışma, kamu hastanelerinin büyük çoğunluğunun etkinliklerinin optimalin üstünde olduğunu göstermiştir. Bu çalışmanın, sağlık alanındaki politikacılara ve yöneticilere hastanelerin etkinliğinin artması konusunda farkındalık sağlaması beklenmektedir.
Kaynakça
- Ahmadkiadaliri, A., Haghparast-Bidgoli, H., & Zarei, A. (2011). Measuring efficiency of general hospitals in the south of Iran [Article]. World Applied Sciences Journal, 13(6), 1310-1316. https://www.scopus.com/inward/record.uri?eid=2-s2.0-84861937765&partnerID=40&md5=177bdc5ee64fc9a9284a05171d09848a
- Ahmed, S., Hasan, M. Z., Laokri, S., Jannat, Z., Ahmed, M. W., Dorin, F., Vargas, V., & Khan, J. A. M. (2019). Technical efficiency of public district hospitals in bangladesh: A data envelopment analysis [Article]. Cost Effectiveness and Resource Allocation, 17(1), 1-10, Article 15. https://doi.org/10.1186/s12962-019-0183-6
- Alatawi, A., Ahmed, S., Niessen, L., & Khan, J. (2019). Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings. Cost Eff Resour Alloc, 17, 17. https://doi.org/10.1186/s12962-019-0185-4
- Alatawi, A. D., Niessen, L. W., & Khan, J. A. M. (2020). Efficiency evaluation of public hospitals in Saudi Arabia: An application of data envelopment analysis [Article]. BMJ Open, 10(1), Article e031924. https://doi.org/10.1136/bmjopen-2019-031924
- Applanaidu, S. D., Samsudin, S., Ali, J., Dash, U., & Chik, A. R. (2014). Technical and Scale Efficiency of Public District Hospitals in Kedah, Malaysia: A Data Envelopment Analysis (DEA) [Article]. Journal of Health Management, 16(3), 327-335. https://doi.org/10.1177/0972063414539595
- Asiabar, A. S., Sharifi, T., Rezapour, A., Khatami Firouzabadi, S. M. A., Haghighat-Fard, P., & Mohammad-pour, S. (2020). Technical efficiency and its affecting factors in Tehran’s public hospitals: DEA approach and Tobit regression [Article]. Medical Journal of the Islamic Republic of Iran, 34, 1-9. https://doi.org/10.34171/mjiri.34.176
- Blatnik, P., Bojnec, Š., & Tušak, M. (2017). Measuring efficiency of secondary healthcare providers in Slovenia. Open Medicine, 12(1), 214-225. https://doi.org/10.1515/med-2017-0031
- Chang, H.-H. (1998). Determinants of Hospital Efficiency: the Case of Central Government-owned Hospitals in Taiwan. Omega, 26(2), 307-317. https://doi.org/10.1016/s0305-0483(98)00014-0
- Chang, H., Cheng, M.-A., & Das, S. (2004). Hospital ownership and operating efficiency: Evidence from Taiwan. European Journal of Operational Research, 159(2), 513-527. https://doi.org/10.1016/s0377-2217(03)00412-0
- Cheng, Z. H., Tao, H. B., Cai, M., Lin, H. F., Lin, X. J., Shu, Q., & Zhang, R. N. (2015). Technical efficiency and productivity of Chinese county hospitals: an exploratory study in Henan province, China [Article]. Bmj Open, 5(9), 10, Article e007267. https://doi.org/10.1136/bmjopen-2014-007267
- Cordero, J. M., García‐García, A., Lau‐Cortés, E., & Polo, C. (2021). Assessing Panamanian hospitals' performance with alternative frontier methods. International Transactions in Operational Research. https://doi.org/10.1111/itor.13013
- Dash, U., Vaishnavi, S. D., Muraleedharan, V. R., & Acharya, D. (2007). Benchmarking the Performance of Public Hospitals in Tamil Nadu. Journal of Health Management, 9(1), 59-74. https://doi.org/10.1177/097206340700900104
- Farrell, M. J. (1957). The Measurement of Productive Efficiency. Journal of the Royal Statistical Society: Series A (General), 120(3), 253-281. https://doi.org/https://doi.org/10.2307/2343100
- Flokou, A., Kontodimopoulos, N., & Niakas, D. (2011). Employing post-DEA Cross-evaluation and Cluster Analysis in a Sample of Greek NHS Hospitals [Article]. Journal of Medical Systems, 35(5), 1001-1014. https://doi.org/10.1007/s10916-010-9533-9
- Fragkiadakis, G., Doumpos, M., Zopounidis, C., & Germain, C. (2016). Operational and economic efficiency analysis of public hospitals in Greece [Article]. Annals of Operations Research, 247(2), 787-806. https://doi.org/10.1007/s10479-014-1710-7
- Giancotti, M., Rotundo, G., Pipitone, V., & Mauro, M. (2018). Efficiency and Optimal size of Italian Public Hospitals: Results from Data Envelopment Analysis [Article]. Epidemiology Biostatistics and Public Health, 15(4), 12, Article e12929. https://doi.org/10.2427/12929
- Gok, M. S., & Altındağ, E. (2015). Analysis of the cost and efficiency relationship: experience in the Turkish pay for performance system. The European Journal of Health Economics, 16(5), 459-469. https://doi.org/10.1007/s10198-014-0584-6
- Haghdoost, A. A., & Moosazadeh, M. (2013). The prevalence of cigarette smoking among students of Iran's universities: A systematic review and meta-analysis. J Res Med Sci, 18(8), 717-725. https://www.ncbi.nlm.nih.gov/pubmed/24379851
- Helal, S. M. A., & Elimam, H. A. (2017). Measuring the Efficiency of Health Services Areas in Kingdom of Saudi Arabia Using Data Envelopment Analysis (DEA): A Comparative Study between the Years 2014 and 2006. International Journal of Economics and Finance, 9(4), 172. https://doi.org/10.5539/ijef.v9n4p172
- Hollingsworth, B., Dawson, P., & Maniadakis, N. (1999). Efficiency Measurement of Health Care: A Review of Non-Parametric Methods and Applications. Health care management science, 2, 161-172. https://doi.org/10.1023/A:1019087828488
- Jat, T. R., & Sebastian, M. S. (2013). Technical efficiency of public district hospitals in Madhya Pradesh, India: a data envelopment analysis [Article]. Global Health Action, 6, 1-8. https://doi.org/10.3402/gha.v6i0.21742
- Kakeman, E., Rahimi Forushani, A., & Dargahi, H. (2016). Technical Efficiency of Hospitals in Tehran, Iran [Article]. Iranian Journal of Public Health, 45(4), 494-502. <Go to ISI>://WOS:000376045100010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888177/pdf/IJPH-45-494.pdf
- Kiadaliri, A. A., Jafari, M., & Gerdtham, U.-G. (2013). Frontier-based techniques in measuring hospital efficiency in Iran: a systematic review and meta-regression analysis. BMC Health Services Research, 13(1), 312. https://doi.org/10.1186/1472-6963-13-312
- Kiani, M., Raei, B., Asbagharani, P., Yousefi, M., Rigi, S., Salehi, M., & Shiraz, S. (2018). Comparison of the technical efficiency of the hospital sector: Panel data analysis of the Iranian hospitals using parametric and non-parametric approaches. Bali Medical Journal, 8, 114. https://doi.org/10.15562/bmj.v8i1.1242
- Kirigia, J. M., Emrouznejad, A., Cassoma, B., Asbu, E. Z., & Barry, S. (2008). A Performance Assessment Method for Hospitals: The Case of Municipal Hospitals in Angola. Journal of Medical Systems, 32(6), 509-519. https://doi.org/10.1007/s10916-008-9157-5
- Kounetas, K., & Papathanassopoulos, F. (2013). How efficient are Greek hospitals? A case study using a double bootstrap DEA approach [Article]. European Journal of Health Economics, 14(6), 979-994. https://doi.org/10.1007/s10198-012-0446-z
- Kuntz, L., Scholtes, S., & Vera, A. (2007). Incorporating efficiency in hospital-capacity planning in Germany. The European Journal of Health Economics, 8(3), 213-223. https://doi.org/10.1007/s10198-006-0021-6
- Li, N. N., Wang, C. H., Ni, H., & Wang, H. (2017). Efficiency and Productivity of County-level Public Hospitals Based on the Data Envelopment Analysis Model and Malmquist Index in Anhui, China [Article]. Chinese Medical Journal, 130(23), 2836-2843. https://doi.org/10.4103/0366-6999.219148
- Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Group, P. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol, 62(10), 1006-1012. https://doi.org/10.1016/j.jclinepi.2009.06.005
- Moosazadeh, M., Nekoei-Moghadam, M., Emrani, Z., & Amiresmaili, M. (2014). Prevalence of unwanted pregnancy in Iran: a systematic review and meta-analysis. Int J Health Plann Manage, 29(3), e277-290. https://doi.org/10.1002/hpm.2184
- O’Neill, L., Rauner, M., Heidenberger, K., & Kraus, M. (2008). A cross-national comparison and taxonomy of DEA-based hospital efficiency studies. Socio-Economic Planning Sciences, 42(3), 158-189. https://doi.org/10.1016/j.seps.2007.03.001
- Osei, D., D'Almeida, S., George, M. O., Kirigia, J. M., Mensah, A. O., & Kainyu, L. H. (2005). Technical efficiency of public district hospitals and health centres in Ghana: a pilot study. Cost Effectiveness and Resource Allocation, 3(1), 9. https://doi.org/10.1186/1478-7547-3-9
- Pham, T. L. (2011). Efficiency and productivity of hospitals in Vietnam [Article]. Journal of Health, Organisation and Management, 25(2), 195-213. https://doi.org/10.1108/14777261111134428
- Polyzos, N. (2012). A three-year Performance Evaluation of the NHS Hospitals in Greece [Article]. Hippokratia, 16(4), 350-355. <Go to ISI>://WOS:000320844300012
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3738611/pdf/hippokratia-16-350.pdf
- Puenpatom, R. A., & Rosenman, R. (2008). Efficiency of Thai provincial public hospitals during the introduction of universal health coverage using capitation. Health care management science, 11(4), 319-338. https://doi.org/10.1007/s10729-008-9057-8
- Ramanathan, R. (2005). Operations assessment of hospitals in the Sultanate of Oman. International Journal of Operations & Production Management, 25(1), 39-54. https://doi.org/10.1108/01443570510572231
- Rezaei, S., Hajizadeh, M., Nouri, B., Ahmadi, S., Rezaeian, S., Salimi, Y., & Karyani, A. K. (2019). Iranian hospital efficiency: a systematic review and meta-analysis. Int J Health Care Qual Assur, 32(2), 385-397. https://doi.org/10.1108/IJHCQA-03-2018-0067
- Rezaei, S., Hajizadeh, M., Zandian, H., Fathi, A., & Nouri, B. (2017). Period Prevalence and Reporting Rate of Needlestick Injuries to Nurses in Iran: A Systematic Review and Meta-Analysis. Res Nurs Health, 40(4), 311-322. https://doi.org/10.1002/nur.21801
- Sendek, S. (2014). Efficiency evaluation of hospitals in the environment of the Slovak Republic [Article]. Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis, 62(4), 697-706. https://doi.org/10.11118/actaun201462040697
- Shone, R. (1981). Applications in intermediate microeconomics.
- Simoes, P., & Marques, R. C. (2011). Performance and congestion analysis of the portuguese hospital services [Article]. Central European Journal of Operations Research, 19(1), 39-63. https://doi.org/10.1007/s10100-009-0122-2
- Sultan, W. I. M., & Crispim, J. (2018). Measuring the efficiency of Palestinian public hospitals during 2010-2015: an application of a two-stage DEA method [Article]. BMC Health Services Research, 18, 17, Article 381. https://doi.org/10.1186/s12913-018-3228-1
- Yeşilyurt, M. E., Şahin, E., Elbi, M. D., Kızılkaya, A., Koyuncuoğlu, M. U., & Akbaş-Yeşilyurt, F. (2021). A novel method for computing single output for DEA with application in hospital efficiency. Socio-Economic Planning Sciences, 76, 100995. https://doi.org/10.1016/j.seps.2020.100995
- Zheng, W. H., Sun, H., Zhang, P. L., Zhou, G. J., Jin, Q. Y., & Lu, X. Q. (2018). A four-stage DEA-based efficiency evaluation of public hospitals in China after the implementation of new medical reforms [Article]. Plos One, 13(10), 17, Article e0203780. https://doi.org/10.1371/journal.pone.0203780