Efficiency measurement of cardiac care units of isfahan hospitals in iran.

The purpose of this study is to evaluate the performance of the Cardiac Care Units (CCU) of hospitals in Isfahan, Iran. The multi-criteria comparison between the wards of different hospitals is not only useful for the patients but also important for the hospitals management to improve their performance and for the medical policy makers to plan strategic decisions. In this paper, it is intended to consider the aspects of efficiency beyond the traditional evaluation of check list. There are some measures which are used in the existing health audit system and several quantified ratios. Among them the most important ones, based on the patient satisfaction and resource efficiency, have been selected using the weights obtained from their paired comparisons. The factors which have been chosen are divided into two subsets: first, input factors consisting of average number of active beds, medical equipment, personnel (such as doctors, nurses and technicians), and technological capabilities, and second, output factors including bed occupancy percentage, average length of stay, total percentage of survival and performance ratio. The input oriented and variable returns to scale model of Data envelopment analysis (DEA) technique is used to evaluate the efficiency of each CCU ward. The model can be used to find out the causes of inefficiency and how to improve the performance. The method has been applied to evaluate and compare 23 CCUs of hospitals in Isfahan. Although the current health audit system, which uses a check list, has reported 21 of them as first class CCU, DEA model reveals that 11 of them are inefficient. The results may be then used to suggest the improvement strategies based on the output factors.