Evaluation of hospital performance in Iran: A systematic review and meta-analysis

Objective (s):  Evaluation of hospital performance helps improve the quality of services, and enhance patients’ health outcomes and satisfaction. This study aimed to evaluate Iranian hospitals’ performance using a systematic review of the last two decades of the literature. A systematic review was conducted to find empirical research publications on Iranian hospitals’ performance between 1997 and 2018. Six electronic databases and two search engines were examined using appropriate key words. Bibliography section of the retrieved papers and related journals were also assessed for papers that were not indexed in the databases yet. All retrieved papers were assessed using a checklist before analysis. In all 2570 publications were identified. Of these 162 empirical studies were reviewed. Studies on evaluation of hospital performance mainly focused on the efficiency dimension and less attention was paid to the effectiveness indicators. In most studies, data envelopment analysis and Pabon Lasso methods were used. Hospitals’ efficiency was reported low to moderate. Some studies used systemic models such as European Foundation of Quality Management and Malcolm Baldrige models for hospital evaluation. In these studies, the results’ scores were lower than the enablers’ scores. Bed occupancy, lengths of stay, bed turnover interval and mortality rate was the most frequently used indicators in evaluating hospitals. Hospital performance studies mainly used non-systemic models and focused more on efficiency aspect of the performance. Systemic and comprehensive models should be considered for hospital performance evaluation.