The Efficiency of Health Performance in Universities of Medical Sciences in Iran: Data Envelopment Analysis

Technical efficiency, which is measured by calculating the ratio of products to resources, is the most important factor in assessing the efficiency status of organizations. Data envelopment analysis is useful to measure the efficiency score of all the units which have homogeneous input resources and output products and to rank them. The aim of this study was to measure and compare the efficiency of health performance in medical universities in Iran. The present research is a cross-sectional study to measure the efficiency of health performance using the national information of the health system of Iran. Input data include hospital beds, specialists, general physicians, dentists, pharmacists, nurses, midwives, computerised topography scan and magnetic resonance imagination devices, and Gini Index; also, the output data include pregnancy care coverage, infant mortality rate, low birth weight, and in-patient days. These data were attained from the annual Ministry of Health and Medical Education report in 2017 for 46 medical universities. To estimate the efficiency of health performance of each medical university using data envelopment analysis, we designed an input-oriented model with Variable Returns to Scale in GAMS 28.2.0. The effect of contextual factors on the efficiency score was calculated using the Tobit Regression model. Results showed that only 19 (41%) medical universities were on the efficiency frontier. The highest mean of efficiency score was attributed to eastern areas, followed by the western and northern areas, and the worst status was related to southern parts of the country. The efficiency scores of universities located in northern areas were closer, while there was more difference among the efficiency scores of the universities of central areas of the country. Tobit regression shows that significant factors inefficiency include life expectancy and medical university class. The results of this study emphasized the differences in the performance efficiency of medical universities. Considering the inefficiency of smaller universities, we need to make careful decisions in establishing new universities in small cities.