Strategies to Improve Hospital Efficiency in Iran: A Scoping Review



Mosadeghrad AM¹ ; Esfahani P² ; Afshari M³ Show Affiliations
Source: Payesh Published:2019

Abstract

Objective (s): Iran hospitals suffer from inefficiency. Thus, managers should take necessary actions to improve hospitals’ efficiency. The purpose of this study was to provide a comprehensive overview of relevant research regarding hospital efficiency strategies in Iran and to identify the gaps in the literature to inform future studies. Methods: The six-stage scoping review framework developed by Arksey and O’Malley was followed. Seven electronic databases and two search engines were examined using appropriate key words to find documents published on hospital efficiency in Iran between March 1997 and October 2017. Bibliography section of the retrieved papers and related journals were also searched for papers that were not yet indexed. A total of 1395 publications were identified, of which 123 publications met inclusion criteria and were reviewed. Data was analyzed using MAXQDA software. Results: The most studies on hospital efficiency strategies were conducted in Tehran, Isfahan and Khuzestan provinces. Fortyone strategies for improving hospital efficiency were found and were clustered into four categories: Meta (Ministry of Health), Macro (university), Mezo (hospital) and Micro (provider). The most frequently mentioned strategies to improve hospital efficiency were quality management, need-based hospital beds allocation, preventing unnecessary hospital beds expansion, economic assessment of hospital performance and providing feedback to managers, appropriate distribution of beds among hospitals and participative management. Conclusion: Policymakers and managers should take necessary coordinated actions at Meta, Macro, Meso and Micro levels to achieve sustained desirable outcomes. © 2019, Iranian Institute for Health Sciences Research. All rights reserved.