Evaluating hospital performance using an integrated balanced scorecard and fuzzy data envelopment analysis

Hospitals are considered as the most important consumer units in the healthcare sector and are one of the main organizations providing health care services. Therefore, efficiency assessment is very important in hospital sectors. Besides, in order to be able to develop and compete, hospitals need a performance evaluation system to evaluate the efficiency and effectiveness of their programs, processes, and human resources. The aim of this paper was to assess the efficiency of hospitals by a combined model of balanced scorecard-fuzzy data envelopment analysis (BSC-fuzzy DEA). The present study was a descriptive-analytical study that was conducted to assess the efficiency of 8 hospitals in Qazvin province in 2018. The required data were collected through historical data and a questionnaire. 30 experts, including hospital managers and staff, and patients were randomly chosen to collect data in each hospital. The methods used in this study were balanced scorecard (BSC) for determining performance indicators in hospitals and fuzzy data envelopment analysis for assessing the efficiency score of hospitals. Data were analyzed by GAMS software version 23.5.1. The results of applying fuzzy DEA revealed that Amiralmomenin Hospital, Bu Ali Clinic, and 22 Bahman Hospital have the best performances among Qazvin hospitals. The technical efficiency scores of these hospitals under the uncertainty level of α=0.75 are 1.72, 1.58, and 1.53, respectively. The use of BSC measures in four perspectives of customer, financial, internal processes and growth, and innovation reflects the overall strategic objectives of the hospitals in the performance evaluation process. Furthermore, applying the BSC and fuzzy DEA methods provides a comprehensive performance assessment tool for hospitals, and helps decision makers to obtain more accurate planning to expand the capacity of health services and save the resources.