title: Technical efficiency of teaching hospitals in Iran: the use of Stochastic Frontier Analysis, 1999-2011.
abstract: BACKGROUND
  Hospitals are highly resource-dependent settings, which spend a large proportion of healthcare financial resources. The analysis of hospital efficiency can provide insight into how scarce resources are used to create health values. This study examines the Technical Efficiency (TE) of 12 teaching hospitals affiliated with Tehran University of Medical Sciences (TUMS) between 1999 and 2011.
  
  
  METHODS
  The Stochastic Frontier Analysis (SFA) method was applied to estimate the efficiency of TUMS hospitals. A best function, referred to as output and input parameters, was calculated for the hospitals. Number of medical doctors, nurses, and other personnel, active beds, and outpatient admissions were considered as the input variables and number of inpatient admissions as an output variable.
  
  
  RESULTS
  The mean level of TE was 59% (ranging from 22 to 81%). During the study period the efficiency increased from 61 to 71%. Outpatient admission, other personnel and medical doctors significantly and positively affected the production (P< 0.05). Concerning the Constant Return to Scale (CRS), an optimal production scale was found, implying that the productions of the hospitals were approximately constant.
  
  
  CONCLUSIONS
  Findings of this study show a remarkable waste of resources in the TUMS hospital during the decade considered. This warrants policy-makers and top management in TUMS to consider steps to improve the financial management of the university hospitals.
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Goudarzi
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Abolghasem
authors.initials: A
authors.lastname: Pourreza
authors.affiliation: Research Center for Modeling in Health, Kerman University of Medical Sciences, Institute for Futures studies in Health, Kerman, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Shokoohi
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Roohollah
authors.initials: R
authors.lastname: Askari
authors.affiliation: Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Mahdavi
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Javad
authors.initials: J
authors.lastname: Moghri
keywords: Hospital; Iran; Stochastic Frontier Analysis (SFA); Technical Efficiency (TE)