Evaluation of the Productivity of Hospitals Affiliated to Lorestan University of Medical Sciences Using the Malmquist and the Kendrick-Creamer Indices

Background: Increasing expenditures in health sector and scarcity of resources are the main bases to investigate productivity and efficiency; such studies are effective in better management of resources and reduction of expenditures and their results can be used as an instrument for policy-making. Objectives: The current study aimed at analyzing the productivity of hospitals affiliated to Lorestan University of Medical Sciences, Lorestan province, Iran. Methods: In the current study, productivity changes of all product factors in the hospitals (N = 12) were evaluated and the means of total factor and marginal productivity were measured using the Malmquist and the Kendrick-Creamer indices from 2010 to 2016. Also, efficient hospitals were ranked based on the Anderson-Peterson coefficient. Results: The changes in the mean total factor productivity were 1.023 using the Malmquist index, which indicated a decrease in productivity during the studied period; however, technological changes had the highest impact in this regard compared with other factors. Also, the means of total factor and marginal productivity of the physicians, nurses, and active bed inputs were 209.06, 38.1, 78.8, and 137.1 using the Kendrick-Creamer index for the studied years, respectively. Conclusions: In the current study, the decreased productivity was mostly attributed to technological changes, which indicates that the hospitals are not equipped properly with advanced medical technologies in terms of diagnosis and treatment processes. Therefore, holding educational courses for personnel for appropriate use of technology as well as optimal resource utilization and improving resource allocation can enhance the productivity and efficiency of all the production factors.