title: Measuring the Efficiency of a Hospital based on the Econometric Stochastic Frontier Analysis (SFA) Method.
abstract: BACKGROUND
  Hospitals are the most expensive health services provider in the world. Therefore, the evaluation of their performance can be used to reduce costs. The aim of this study was to determine the efficiency of the hospitals at the Kurdistan University of Medical Sciences using stochastic frontier analysis (SFA).
  
  
  METHODS
  This was a cross-sectional and retrospective study that assessed the performance of Kurdistan teaching hospitals (n = 12) between 2007 and 2013. The Stochastic Frontier Analysis method was used to achieve this aim. The numbers of active beds, nurses, physicians, and other staff members were considered as input variables, while the inpatient admission was considered as the output. The data were analyzed using Frontier 4.1 software.
  
  
  RESULTS
  The mean technical efficiency of the hospitals we studied was 0.67. The results of the Cobb-Douglas production function showed that the maximum elasticity was related to the active beds and the elasticity of nurses was negative. Also, the return to scale was increasing.
  
  
  CONCLUSIONS
  The results of this study indicated that the performances of the hospitals were not appropriate in terms of technical efficiency. In addition, there was a capacity enhancement of the output of the hospitals, compared with the most efficient hospitals studied, of about33%. It is suggested that the effect of various factors, such as the quality of health care and the patients' satisfaction, be considered in the future studies to assess hospitals' performances.
authors.affiliation: Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Satar
authors.initials: S
authors.lastname: Rezaei
authors.affiliation: Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
authors.forename: Hamed
authors.initials: H
authors.lastname: Zandian
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Akram
authors.initials: A
authors.lastname: Baniasadi
authors.affiliation: Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Telma Zahirian
authors.initials: TZ
authors.lastname: Moghadam
authors.affiliation: Department of Medical Education, School of Medicine And Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Somayeh
authors.initials: S
authors.lastname: Delavari
authors.affiliation: Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Sajad
authors.initials: S
authors.lastname: Delavari
keywords: hospital; stochastic frontier analysis; technical efficiency