RESUMO
Proper site selection, number of manpower and their composition, physical space, optimal allocation of resources, active beds etcare the most important factors affecting the cost of current construction, income and other financial institutions in hospitals. This study assesses economic relationship between physical spaces and the hospital costs and determines hospital scale efficiency in selected hospitals across the country. This is a descriptive study which was conducted in 1386 in139 hospitals [out of 530] covered by the medical universities throughout the country. The sample hospitals selected and grouped based on a combination of factors such as be a teaching and non-teaching hospital, located in deprived and rich areas and also size of hospitals in terms of number of active beds. Information was collected using a questionnaire designed for the study and also through hospital websites. The collected Information included the number of employees, total hospital expenditures and income and information about the physical space of all wards in the hospitals. Findings: Out of total 650/4 hectares physical space of the hospitals, 240/5 hectares were developed [structured building], which 117/3 hectares allocated to treatment [clinical] and rest was administrative and supportive service. The results showed that the hospitals in the second and third groups had lower maintenance costs than the other groups, in a way that they could have more than 10.5% savings of scale through development of hospitals from first into third group
RESUMO
Hospitals are known as one of the main health care providing organizations. Increasing expenditures is claimed to be one of the most serious problems in hospitals. In this context, economic analyzing is very essential for health system evidence based decision making. We aimed to collect and analyze the hospital resources and this article specially is going to clarify the human resources arrangement in hospitals affiliated with ministry of health. This is an Applied Cross Sectional study, which was performed on 139 hospitals in 2009. We were going to collect the data from all Iranian hospitals affiliated with MOHME. In this regard, an expert's panel defined some inclusion criteria and finally 139 out of 530 hospitals were selected. Nine online questionnaires were used to collect data. We categorized the hospitals on the basis of bed numbers, being educational or non educational and locating in poor or rich areas [A: below 50 beds, B: 51-150 beds, C:151-300 beds and D: above 300 beds]. We analyzed the data using SPSS software. In 139 hospitals, there were 23674 active beds and 48238 personnel [2.04 personnel per each bed]. Our data showed that 48.4 percent of personnel had an under-associate degree, 40% had bachelor degree and the rest had higher degrees. Nurses and midwives were 48.1 percents of all personnel. Average bed occupancy rate was 57.8% and the lowest bed occupancy rate was belonged to the under 50 bed hospitals [31.4%]. The ratio of clinical personnel in teaching hospitals [71.1%] was higher than the non-teachings [70.4%]. This ratio was higher in rich areas [71.2%] compared to the poor areas [68.7%]. The proportion of number of personnel per bed in teaching hospitals [2.09] was higher than non-teaching hospitals [1.9]. This proportion was lower in rich areas [2.02] than the poor areas [2.17]. The density of logistic personnel was higher [29.1]than the other personnel. The high density of logistic personnel is a sign of low efficiency in selected hospitals. Despite of increasing ratio of clinical personnel to total number of personnel, the ratio of medical personnel per beds was decreasing and this can be a sign of low quality and effectiveness. Big hospitals have a better bed occupancy rate compared to small ones