رابطه اعتباربخشی و کارایی در بیمارستان‌های عمومی ایران: گزارش کوتاه

زمینه و هدف: اعتباربخشی بیمارستانی فرآیند ارزشیابی رسمی نظام‌مند و تعیین اعتبار بیمارستان توسط یک سازمان مستقل خارجی با استفاده از استانداردهای مطلوب ساختاری، فرآیندی و پیامدی است. هدف این پژوهش بررسی رابطه بین کارایی و وضعیت اعتباربخشی بیمارستان‌های عمومی ایران است.روش بررسی: این مطالعه توصیفی و مقطعی در اردیبهشت 1398 انجام شد. کارایی بیمارستان‌های عمومی ایران در سال 1396 با استفاده از نمودار پابن لاسو و شاخص‌های عملکردی، درصد اشغال تخت و گردش تخت بیمارستان تعیین و ارتباط آن با درجه اعتباربخشی بیمارستان‌‌ها بررسی شد.یافته‌ها: بیمارستان‌های عمومی کشور دارای میانگین اشغال تخت 62.8%، میانگین طول اقامت بیمار 2.6 روز و میانگین گردش تخت 93.4 بار در سال 1396 بودند. حدود 15.3% بیمارستان‌ها کارایی خوبی داشتند و در ناحیه سه نمودار پابن لاسو قرار گرفتند. بین درجه اعتباربخشی بیمارستان‌ها با درصد اشغال تخت، گردش تخت و فاصله گردش تخت آن‌ها ارتباط معناداری مشاهده شد (p<0/01).نتیجه‌گیری: کارایی بیمارستان‌های عمومی ایران پایین است. درجه اعتباربخشی با برخی از شاخص‌های عملکردی بیمارستان‌ها مرتبط است.

Relationship between accreditation and efficiencyin iranian public hospitals: brief report

Background: Hospital accreditation is a systematic external evaluation of a hospitalchr('39')s structures, processes, and outcomes by an independent professional accreditation body using published optimum, evidence‐based, and achievable standards. Accreditation is a strategy for ensuring the quality, safety, and productivity of hospital services. Implementing accreditation standards imposes a high cost on hospitals. Therefore, this cost should be offset by increased hospital efficiency. Hence, this study aimed to examine the relationship between the Iranian public hospitals rsquo; efficiency and their accreditation status.Methods: This descriptive and crosssectional study was conducted in May 2019. The efficiency of general hospitals in Iran was assessed using the Pabon Lasso chart and three performance indicators of bed occupancy rate, average patient length of stay and hospital bed turnover. Then, the relationship between the efficiency of hospitals and their accreditation grade was examined. Descriptive statistics and ANOVA tests were used for data analysis using SPSS software.Results: There were 834 general hospitals with 108,275 active beds in Iran in 2018. The Iranian general hospitals had an average bed occupancy of 62.8%, an average patient length of stay of 2.6 days, and an average bed turnover of 93.4 times. Almost 15.3% of the hospitals performed well and were located in area 3 of the Pabon Lasso chart. About 36.1% and 48.6% of the hospitals had moderate and low efficiency, respectively. Approximately, 74% and 21% of hospitals had the accreditation status of 1 and 2, respectively. There was a significant relationship between the degree of accreditation of hospitals with their bed occupancy, bed turnover and bed turnover interval.Conclusion: The efficiency of public hospitals is low. A hospital accreditation grade is related to some of its efficiency indicators. Low efficiency and waste of resources will reduce the effectiveness of hospital and, consequently, its accreditation grade. Accordingly, the hospitalchr('39')s revenue will decrease and therefore, the hospitalchr('39')s productivity and accreditation grade will decrease and the hospital will be in a vicious cycle. Strengthening hospital accreditation standards and their proper implementation will increase the efficiency of hospitals.