Assessment of Resource Distribution and Performance Evaluation of Iranian Military Hospitals in 2018 Based on Pabon Lasso Model

Despite the inadequate resources allocated to the health sector, in most developing countries, the allocation and proper utilization of these limited resources is also not based on proper planning; therefore, the efficiency of the health sector is less than expected. The aim of this study was to determine the status of resource distribution and performance evaluation of Iranian military hospitals.

This cross-sectional study involved all the military hospitals in Iran (57 hospitals). Data including hospital status and types of hospital beds, performance indicators, status of hospital resource access indexes, and staffing status in hospitals by separate organizations were extracted from the annual statistics and hospital information reported by the Deputy Minister of Health. Excel 2013 software was used to collect and calculate the data and ArcMap v.10 software was used to design the geographical map and Pabon Lasso model was used to measure the efficiency.

The Armed Forces Organization has Iran's hospitals, active beds and stellar beds, with 5.7%, 4.2 % and 4%, respectively. It also has 4.3 %, 3.77 % and 4.97 % of ICU, NICU and CCU beds, respectively. In 80 percent of border provinces, there is at least one military hospital, and Tehran province has the most military hospitals with 13. Military hospitals employ 1.9%, 1.46 % and 2.37 % of hospital personnel, nurse and physician, respectively. Bed occupancy ratio and bed turnover index in military hospitals were higher than the national average and the average of length of stay index was lower than the national average, which indicates that hospitals affiliated with the Armed Forces perform better than other hospitals. However, according to the Pabon Lasso Model, 37 percent of Iran's military hospitals had good performance, 37 percent had poor performance, and 26 percent had moderate performance.

Based on the results of the present study, the Armed Forces Organization as the fourth provider of hospital services and having a significant share of hospital resources in the country, despite acceptable performance, requires special attention to optimally utilize existing resources through increasing the hospitals efficiency.