Annals of Tropical Medicine and Public Health

: 2017  |  Volume : 10  |  Issue : 4  |  Page : 884--890

Investigation of Iranian hospitals' efficiency using Pabon Lasso model: Systematic Review

Marya Parvaresh, Afshin Esfandnia 
 Department of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran

Correspondence Address:
Marya Parvaresh
Kermanshah University of Medical Sciences, Kermanshah


The purpose of this study was to evaluate the performance of hospitals in Iran using Pabon Lasso model. In this descriptive study, both Persian and English papers about performance, function and Pabon Lasso model were searched in Iranian databases: Scientific Information Database Information Bank Country (Magiran), Banks Articles of Medical Sciences (Iranmedex), Science Direct, ISCCSI, PubMed, ProQuest, and Google Scholar. The study population was comprised 386 hospitals and 24 articles that 18 articles were valid and used in research. A total of 386 hospitals, of which 98 hospitals (25.4%) had a poor performance in the first zone, 79 hospitals (20.4%) had moderate performance in the second zone, 123 hospitals (32.1%) had a great performance in the third zone, and 86 hospitals (22.1%) were relatively modest performance in the fourth zone. Given that the most of the hospitals have above average performance, it is necessary to perform detailed plans for the optimal use of human and material resources in hospitals.

How to cite this article:
Parvaresh M, Esfandnia A. Investigation of Iranian hospitals' efficiency using Pabon Lasso model: Systematic Review.Ann Trop Med Public Health 2017;10:884-890

How to cite this URL:
Parvaresh M, Esfandnia A. Investigation of Iranian hospitals' efficiency using Pabon Lasso model: Systematic Review. Ann Trop Med Public Health [serial online] 2017 [cited 2020 Jul 13 ];10:884-890
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Health is the basis of sustainable social, economic, political, and cultural development in all human communities, and it is of the essence in the infrastructure of different sectors of societies. Aside from the duty to promote the health, social and economic issue, and any kind of planning health, therapy services to be part of a comprehensive approach health policy and eventually form part of integrated sustainable development.[1] Over the past decade, most countries in particular in the health sector are faced with a significant increase in health-care costs in general and the growth of hospital costs so that full satisfaction of consumers' needs in this sector, even worldwide, seems impossible, which doubles especially in developing countries due to their economic infrastructure and acute vulnerability.[2] Hospital as one of the main organizations providing health care and sensitivity is particularly important in health economics. This feature, especially in developing countries, according to the economic infrastructure and severe vulnerability in the face of fluctuations in currency and commodity markets will be double. because the rising demand for health-care goods and services are faced with limited resources, so full satisfaction of the needs of customers in this sector, even in the most advanced countries of the world, is practically impossible.[3] In this regard, the hospitals as the biggest and most costly health system operating unit are of particular importance. Hospitals, approximately 80%–50% of the total resources, allocated to the health sector.[4] Because they are the largest and most costly performing unit of health systems.[5] Moreover, a large share of educated workers has the highest levels.[4] Hospitals in the country's health-care system are very serious situation and a very heavy responsibility. These centers of attention to matters that are crucial disquisitions and secured function properly and responsibly health community is indebted to them.[5] Iranian hospitals consume a large share of GDP and the budget for health care.[6] Moreover, due to the growing need for applying scarce resources and improving efficiency in the delivery of health care, it is prominent importance to take some precautionary measures towards prevention and reduction of wasting resources dedicated to this part of healthcare system with the aim of providing more services, expanding access, and improving the quality of hospital services.[7] More importantly, over 80% of the resources spent on hospitals, which have an efficiency of <50% of their capacity.[8] Efficiency can be defined as the maximum use of existing resources to produce more products to be produced as a product or service at the lowest cost. Indicators used to measure the efficiency of hospital bed occupancy rate (BOR), average length of stay patient, and their bed turnover rate.




Measuring the quality of health services is extremely difficult because the outcome of service facility is not certainly clear and measurable.[5] To determine the effectiveness or ineffectiveness, every business should use the appropriate index or indices as a basis for comparison. There are different ways to measure efficiency in hospitals; often in related studies, two methods are u two methods are used to measure the efficiency of parametric or nonparametric methods.[9] One of the most useful ways to compare the performance of different hospitals or different departments in a hospital from the point of view of efficiency is using Pabon Lasso model. The technique introduced in 1986 by someone of the same name and then was used to evaluate the efficiency in hospitals. The difference between the operation of the data in hospitals in different regions and countries can be examined using this model [Table 1] and [Table 2].[10]{Table 1}{Table 2}

 Materials and Methods

This study was descriptive and just review (Literature review) is that articles published between the years 2001–2015[Table 3] were studied. To achieve scientific documentation, in both Persian and English electronic search using keyword performance, function, Pabon Lasso model, Iran Databases: Scientific Information Database Information Bank Country (Magiran), Banks Articles of Medical Sciences (Iranmedex), Science Direct, ISCCSI, PubMed, ProQuest, and Google Scholar, was carried out. The study population consisted of 386 hospitals and 24 papers were printed papers to stage the inclusion criteria included (1) conduct research in Iran, (2) research related to the evaluation of efficiency in hospitals, (3) study conducted between the years 2002 and 2015, (4) publishing in languages, (5) the full text of articles, and (6) having the structure was appropriate. Articles that were no such measures were not examined [Table 4]. To check the quality of collected paper, three researchers began to review the article title, abstract, introduction, methods, results, discussion, and sources of support. That article 18 is valid and usable in the study.{Table 3}{Table 4}

 Results and Discussion

[Table 5] shows that 32.1% of hospitals in the third graph, which shows that the BOR and bed turnover rate are high in this zone. The results showed that most hospitals of Iran in Part III were Pabon Lasso graph which shows the excellent performance, Ayat hospital is part of the graph. The results of Sadaghiani showed that countries Fei Ji, Zimbabwe, France, America, and Jamaica, this model is in the third zone.[14] The results showed that 27.5% of Moheddine Younsi 2014 in Tunisia were in the zone. Hence, we can say that hospitals in the zone have a good occupancy rate and bed turnover is high, so are efficient. The findings show that 25.4% of hospitals were in the first. The results of Sadaghiani showed that Ethiopia, Korea, Morocco, and Turkey were in the first zone of the graph.[14] The results showed that 47.5% of Moheddine Younsi 2014 in Tunis hospital were in a zone. Given that this part of the diagram represents the occupancy rate and bed turnover is below the acceptable average, hence we can say that the hospital lacked the efficiency needed in this zone. The poor performance but because of reasons such as having additional beds in demand diversion cases to other centers and stay high (which may compensate for the lack of demand). The results showed that 20.4% of hospitals were in the second zone. The results of Sadaghiani showed that Iran, Jordan, and Brazil are in the zone.[14] The results showed that 7.5% of Moheddine Younsi 2014 in Tunisia were in the second zone. Given that in this zone, hospitals with an BOR although they are lower than average, Hospitals with bed turnover above the average can be said that most hospitals for obstetrics and gynecology and Short-term inpatient hospitals in sparsely populated counties are in this group that represents the average efficiency of hospitals are in the zone. The results also showed that 22.1% of hospitals in the fourth. The results of Sadaghiani showed that Tunisia, Argentina, China, and Nigeria are in the zone four.[14] The results showed that 17.5% of Moheddine Younsi 2014 in Tunisia hospitals was located in the zone. Due to the high occupancy rate, but the district hospital bed turnover low can be said that hospitals in the zone long-term hospitalization and operation of existing facilities and high costs are low. Usually, centers, psychiatric and geriatric medicine are in this group.{Table 5}


Therefore, it is suggested that the increase in BTR and BOR and hospitals trying to reduce LOS, to reach the third area Pabon Lasso graph that shows relatively good performance. It is also proposed that hospitals be judged based on international standards, in which case probably will be mostly in the area of El charts

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Conflicts of interest

There are no conflicts of interest.


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