PERFORMANCE ASSESSMENT OF HEALTH SYSTEM REFORM PLAN IN THE HOSPITALS AFFILIATED WITH URMIA UNIVERSITY OF MEDICAL SCIENCES

Performance and efficiency assessment are two significant factors affecting the
efficient evaluation of health system reform plan, and can help executive agents in better recognition of
its strengths and weaknesses, and try to improve it. This study was conducted to compare the efficiency
of hospitals affiliated with Urmia University of Medical Sciences, before and after the implementation
of the reform plan.
Materials & Methods: This was an analytical-description study conducted in 23 hospitals of Urmia
Medical Science University in the years 2013-14. To collect data, a checklist with input variables of the
number of nurses, doctors, active beds, and other personnel and output variables of the number of
discharges, surgeries and bed occupancy percentage for estimating technical, scale and managerial
efficiency indexes of the hospitals to each year by Windeap2.1 software, was used.
Results: Reform plan has affected technical, managerial and scale efficiency, and the average of them
reached respectively from 0.772±0.225, 0.877±0.193 and 0.878±0.144 in 2013 to 0.886±0.141,
0.941±0.116 and 0.941±0.090 in 2014. Therefore, it reflects improvement in performance due to health
system reform plan. Before implementation of reform plan 21.74% of hospitals have acted as inefficient,
while after the implementation, this amount has decreased to 8.70%. Meanwhile, after the
implementation of health reform plan, the performance of some hospitals was reduced considerably.
Conclusions: According to allocation of high percentage of budget from Health Ministry to health
system reform plan, monitoring and periodic evaluation of performance are necessary factors in
increasing the efficiency. After implementation of reform plan and decrease in the medical cost,
hospitals were faced with increasing referral of patients and bed occupancy. Lack of supply of required
facilities and human resource proportional in increasing of referral load to provide cares were most
common causes of reduced performance in inefficient hospitals