Showing 6 results for Efficiency
A Ardalan , K Holakouie Naieni , M Mahmoudi , R Majdzadeh , P Derakhshandeh Peykar ,
Volume 4, Issue 2 (5-2006)
Abstract
Background and Aim: Limitations of the traditional methods for assessing G*E interaction- including case-control studies- led to development of several non-traditional approaches. This study aims to assess the interaction between the genetic background (history of breast cancer in first degree relatives) and environmental influences (reproductive/menstrual factors) in patients with breast cancer we also compare the statistical efficiency and power of case-control and case-only designs in this setting.
Materials and Methods: In a matched case-control study in Mazandaran province (Iran), 250 incident biopsy-proven cases of breast cancer and 250 age-matched neighbor controls were interviewed. History of breast cancer in mother and/or sister(s) was taken as a surrogate measure of genetic predisposition, while age at first birth, parity, breast feeding, age at menarche and irregular menstruation were considered as relevant environmental factors. For the matched case-control design, we used a conditional logistic regression model to examine main effects and the G*E interaction. In the case-only design, logistic regression analysis was applied to obtain an estimate of G*E interaction, after checking for the independence assumption. We also calculated the power for detecting the interaction by matched case-control and case-only analyses.
Results: Age at first delivery did not meet the assumption of independence (p=0.02), and so was not included in the case-only analysis. No statistically significant interaction effect was seen in the case-control analysis, while case-only analysis showed significant negative interaction between disease in first-degree relatives on the one hand and parity and breast feeding on the other. We also detected a significant positive interaction between genetic predisposition and age at menarche. All the estimated 95% confidence intervals for OR in G*E interactions were narrower in the case-only analysis. For all factors, the power for detecting G*E interaction was greater in the case-only analysis compared to the case-control analysis, with ratios ranging from 1.08 to 2.23.
Conclusion: The case-only design is more efficient and powerful than the case-control design for detecting gene-environment interaction under the assumption of independence. Baseline disease risk, interactions and independent effects should be considered in using the control data for checking the assumption of independence. Considering the existence of another explanatory variable, eg. a mutant gene which may have passed unnoticed, would be the safest approach in a case-only study.
M Faghihnasiri, J Rezaee , M Tavakoli Baghdad Abad,
Volume 7, Issue 3 (10-2009)
Abstract
Background and Aim: By definition, the ratio of output to input in any firm is called efficiency. In general, there are two main approaches for measuring efficiency ─ parametric and non-parametric. The objective of this study was to assess the efficiency of Health Services Workshops in Iran in 2006.
Methods and Materials: The efficiency of Health Services Workshops in Iran in 2006 was assessed using the non-parametric method, based on linear programming. More specifically, the Data Envelopment Analysis (D.E.A) was used. The most important feature of the Data Envelopment Analysis (D.E.A) is its applicability for the firms that operate under a multiple input-and-output framework. Assessment of efficiency was based on 2 assumptions, namely, fixed and variable efficiency.
Results: The data show that, based on fixed efficiency, the efficiency in the Bushehr, Fars, Kerman, Mazandaran and Yazd provinces is the highest, the average being 80%, which means that the idle capacity is 20% . Based on the variable efficiency. assumption, in Ilam, Chahar Mahal-and-Bakhtiari, Semnan, and Kohgiluyeh Boyerahmad provinces the efficiency is 85% (idle capacity = 20%).
Conclusion: On the whole, the Chaharmahal-Bakhtiyari province is the most efficient in holding Health Services Workshops in Iran. Therefore, other provinces should follow this province as an example when planning to increase their efficiency.
A Pourreza, Gh Goudarzi, H Azadi,
Volume 7, Issue 4 (2-2010)
Abstract
Background and Aim: The hospital is considered as the biggest and the most costly unit of a health care system. Therefore, paying full attention to its cost efficiency is very important. The objective of this study was to assess the technical efficiency of hospitals affiliated with Tehran University of Medical Science by data envelopment analysis method.
Materials and Methods: Technical efficiency in hospitals affiliated with Tehran University of Medical Sciences was assessed by Data Envelopment Analysis (DEA) from 1996 to 2006. The input-oriented form of variable return-to-scale (VRS) was used to collect the data using 4 inputs (number of beds, nursing staff, medical personnel, and other personnel) and 4 outputs (outpatient admissions, hospitalized-patient days, bed occupations, and the number of surgical operations performed). The software used for data analysis was Deap 2.1.
Results: The DEA results indicate that: 1.There is a potential to improve the hospital technical efficiency by 3 % (the mean technical efficiency of the hospitals was 0.972) 2. Constant return-to-scale (CRS) exists in the production process, meaning that production in the hospitals is at its optimum level 3. Hospital services have suffered from extra production factors, especially human resources (specifically the nursing staff).
Conclusion: With proper planning, limiting the number of personnel can reduce greatly health care costs and hospital expenditures. It is suggested to conduct studies to determine the effects of the quality of services delivered in hospitals and patient satisfaction on hospital technical efficiency.
Farideh Golbabaei, Ali Faghihi-Zarandi, Ahmadreza Shokri, Mohammadreza Baneshi, Pedram Ebrahimnejad, Asghar Sedigh Zadeh,
Volume 10, Issue 2 (10-2012)
Abstract
Background and Aim: Bioaerosols are one of the most important agents that cause post operating infections in hospitals. Surgical masks are recommended for prevention of bioaerosols transmition in operating rooms. This study aimed at evaluation of submicron particle filtration efficiency of domestic and imported surgical masks.
Materials and Methods: In this cross sectional study, 5 types of surgical masks that have the most utilization in operating rooms of country’s hospitals including domestic and imported surgical masks were tested. To evaluate all samples, the submicron particle filtration measurements were carried out based on ISIRI 6138 and American DOP standards. Filtration efficiency calculations and pressure drop measurements were performed and the results were analyzed using statistical tests.
Results: Results showed that particle filtration efficiency of domestic and imported masks were 56.130% (±10.7) and 31.906% (±7.062) respectively. Also, filtration efficiency in domestic masks were more than imported masks (P> 0.001). Among all samples, Arman mask had the most filtration efficiency (66.5475 % ±6.14951), where the least (27.8275 % ±4.44152) filtration efficiency (P> 0.001) belongs to Blosom. The maximum mean of pressure drop in Arman mask (35 ±2. 58 Pa) and the least mean of pressure drop in Zist filter mask (11 ±1.82 Pa) were observed.
According to the effect of filtration efficiency and pressure drop on general quality of mask, the quality factor of masks were also evaluated. Results showed that Zist filter mask had the most quality factor (0.068) while Blosom had the least quality factor (0.016).
Conclusion: This research showed that domestic surgical masks have a better quality toward imported surgical masks but can not obtained quality confirmed by standards, yet.
To reduce respective infections and prevalence of diseases, it is recommended using filters with suitable physical characteristics and also carrying out test of surgical masks before supplying.
Hamid Sepehrdust, Elham Rajabi,
Volume 10, Issue 3 (1-2013)
Abstract
Background and Aim: Hospitals as one of the major institutions providing health care services within the health sector utilize a high percentage of the sector's key resources to respond to the needs of consumers. The aim of the present study was to identify factors affecting technical, scale and management efficiency of the Social Security Organization (SSO) hospitals during the period 2007-2009 and find ways to improve the efficiency of inefficient hospitals.
Materials and Methods: A total of 65 SSO hospitals active during the period 2007-2009 were included in the study. Data envelopment analysis was used assuming constant return to scale of production (CRS). To distinguish between management and scale efficiency of hospital units, the study used input-oriented model (BCC) assuming variable return to scale (VRS).
Results: The findings showed that small hospitals with less than, and large hospitals with more than, 100 active beds have 11% and 8.8% surplus inputs, respectively, the surplus inputs being medical and nursing staff, other personnel, as well as active beds for hospital services. In addition, the impact factors of medical staff, nursing staff, other personnel, and active beds were 24%, 9.8%, 11.7% and 16.8% for small hospitals' efficiency and 25.7%, 18%, 21.7% and 30.7% for large hospitals' efficiency, respectively..
Conclusion: Considering the average scale and management scores derived for efficiency measurement, it is recommended that the Social Security Organization hospitals reduce their surplus costs and increase their output products and services to achieve the optimum level of efficiency.
Ali Mohammad Mosadeghrad, Ensiyeh Ashrafi,
Volume 15, Issue 4 (3-2018)
Abstract
Background and Aim: Quality management, as an organizational strategy, helps enhance hospital effectiveness and efficiency. This study aimed to examine the effect of a quality management model on the efficiency
of the respiratory intensive care unit in Labafijejad Hospital, Tehran in 2013-14.
Materials and Methods: This was a participatory action research conducted in
the respiratory intensive care unit in Labafijejad Hospital, Tehran in 2013-14. A quality improvement team was formed to implement the quality management system and promote working processes. The team identified and standardized working processes, determined the quality goals for the processes, and improved the processes based on the 10-stage Mosaddeghirad Quality Management model. Performance indicators of the unit (bed occupancy, bed turnover, and bed interval rates; patient average length of stay in the ward) were calculated and compared before and after the intervention.
Results: Implementing quality management brought about an increase of 2.8% and 19.2% in bed occupancy rate and bed turnover rate, respectively, as well as a decrease of 14.1% in patient average length of stay and a decrease of 35.6% in bed interval rate in the respiratory intensive care unit of the hospital.
Conclusion: Implementing quality management can increase the efficiency of the respiratory intensive care unit of a hospital. A suitable quality management system and the commitment of the hospital manager and staff can result in enhancement of efficenicy in a hospital.
