scholarly journals A systematic review on hospital inefficiency in the Eastern Mediterranean Region: sources and solutions

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hamid Ravaghi ◽  
Mahnaz Afshari ◽  
Parvaneh Isfahani ◽  
Victoria D. Bélorgeot

Abstract Background Evaluating hospital efficiency is a process to optimize resource utilization and allocation. This is vital due to hospitals being the largest financial cost in a health system. To limit avoidable uses of hospital resources, it is important to identify the sources of hospital inefficiencies and to put in place measures towards their reduction and elimination. Thus, the purpose of this research is to examine the sources of hospital inefficiency in the Eastern Mediterranean Region, and existing strategies tackling this issue. Methods In this study, the electronic databases MEDLINE (via PubMed), Web of Science, Embase, Google, Google Scholar, and reference lists of selected articles, were explored. Studies on inefficiency, sources of inefficiency, and strategies for inefficiency reduction in the Eastern Mediterranean region hospitals, published between January 1999 and May 2018, were identified. A total of 1466 articles were selected using the initial criteria. After further reviews based on the inclusion and exclusion criteria, 56 studies were eligible for this study. The chosen studies were conducted in Iran (n = 35), Saudi Arabia (n = 5), Tunisia (n = 5), Jordan (n = 4), Pakistan (n = 2), the United Arab Emirates, Palestine, Iraq, Oman, and Afghanistan (n = 1 each). These studies were analyzed using content analysis in MAXQDA 10. Results The analysis showed that approximately 41% of studies used data envelopment analysis (DEA) to measure hospital efficiency. Sources of hospital inefficiency were divided into four categories for analysis: Hospital products and services, hospital workforce, hospital services delivery, and hospital system leakages. Conclusion This study has revealed some sources of inefficiency in the Eastern Mediterranean Region hospitals. Inefficiencies are thought to originate from excess workforce, excess beds, inappropriate hospital sizes, inappropriate workforce composition, lack of workforce motivation, and inefficient use of health system inputs. It is suggested that health policymakers and managers use this evidence to develop appropriate strategies towards the reduction of hospital inefficiency.

2020 ◽  
Author(s):  
Hamid Ravaghi ◽  
Mahnaz Afshari ◽  
parvaneh Isfahani ◽  
Alireza Mahboubahari ◽  
Victoria D Belorgeot

Abstract Background: Recent rising costs and shortages of healthcare resources make it necessary to address the issue of hospital efficiency. Increasing the efficiency of hospitals can result in better and sustainable achievement of their organizational goals.The purpose of the present research is to examine hospital efficiency in the Eastern Mediterranean Region (EMR).Methods: This study is a systematic review and meta-analysis of all articles published on hospital efficiency in Eastern Mediterranean countries between January 1999 and May 2018, identified by searching three databases (PubMed through MEDLINE, Web of Science, and Embase) and two search engines (Google and Google Scholar). The reference lists of these articles were checked for additional relevant studies. Fifty articles were finally selected, and data was analyzed through the Comprehensive Meta-Analysis Software (v.2.2.064). Results: Using the random-effects model, the mean hospital efficiency in Eastern Mediterranean hospitals was 0.829 ± 0.026 at 95% CI. Three approaches were used to measure hospital efficiency: data envelope analysis (DEA), stochastic frontier analysis (SFA), and Pabón Lasso Analysis. Different mean and standard deviation values were obtained from DEA (0.428±0.024), DEA and Pabón Lasso Analysis (0.925±0.029), Pabón Lasso Analysis (0.790±0.086) and SFA (0.594±0.056), due to the different inputs and outputs used in these methods. Technical efficiency (TE) was higher in some countries such as Iraq (0.976±0.035), Oman (0.926 ± 0.032), Jordan (0.924±0.060) and Saudi Arabia (0.917±0.023). Conclusion: Efficiency plays a significant role in hospital growth and development. It is therefore important for healthcare managers and policymakers in the EMR to identify the causes of inefficiency, to improve TE and develop cost-effective strategies.


Crisis ◽  
2020 ◽  
Vol 41 (Supplement 1) ◽  
pp. S72-S79 ◽  
Author(s):  
Mohsen Rezaeian ◽  
Murad Moosa Khan

Abstract. The WHO Eastern Mediterranean Region (EMR) consists of 22 countries including Afghanistan, Bahrain, Djibouti, Egypt, Iraq, Islamic Republic of Iran, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic, Tunisia, United Arab Emirates (UAE), and Yemen. According to Global Burden of Disease (GBD) data, death from self-harm has increased by 100% between 1990 and 2015 in this region. Although this increase is substantial, it appears trivial in comparison to the 1027% increase in deaths due to war and legal interventions. This might partly explain why suicide prevention does not have a high priority in these countries and why there are currently no suicide prevention strategies in place. Despite the above, some important activities in the area of suicide prevention have been carried out in the region. And while peace and stability may take time to come to the region, it should not prevent suicide prevention programs from being developed and implemented.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Christine S Autenrieth ◽  
Regina Guthold ◽  
Melanie J Cowan ◽  
Laura Kann ◽  
Faten Ben Abdelaziz ◽  
...  

Background: Overweight and obesity, physical inactivity, and sedentary behavior are important risk factors for chronic diseases; however, for the youth in countries of the Eastern Mediterranean Region (EMR), comparable prevalence data are lacking. Methods: We used data from nationally representative samples of 34,410 13-15 year old schoolchildren who participated in the Global School-based Student Health Survey (Djibouti, Egypt, Jordan, Lebanon, Libyan Arab Jamahiriya, Morocco, Oman, Pakistan, Tunisia, United Arab Emirates, and Yemen). Data on height, weight, physical activity levels, and sedentary behavior were collected from 2005-2009 in these eleven EMR countries and sex- and country-specific prevalence rates were calculated. Results: The prevalence of overweight and obese youth ranged from 6.5% in Pakistan (boys: 5.1%, girls: 8.7%) to 37.6% in the United Arab Emirates (boys: 39.2%, girls: 36.1%), whereas underweight was highest in Yemen (20.8%; boys: 25.4%, girls: 13.0%) and lowest in Egypt (4.0%; boys: 4.7%, girls: 3.2%). Six of the eleven countries had an overweight and obese rate higher than 20%. The combined risk factors of overweight, insufficient amount of physical activity (< 5 days of at least 60 minutes per week), and sedentary behavior (≥ 3 hours of sitting activities per day) ranged from 0.5% in Pakistan to 12.3% in the United Arab Emirates. Conclusion: These data suggest that prevalence of overweight schoolchildren is high in EMR countries. In addition, physical activity levels were below recommendation guidelines in most of the surveyed countries. Efforts to prevent these unfortunate trends should be taken on regional and national levels.


F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 1287
Author(s):  
Ayoub Al-Jawaldeh ◽  
Rania Megally

Background: Prevalence of overweight and obesity is high in the Eastern Mediterranean Region, and there are higher rates in Gulf Cooperation Council (GCC) countries. This had led GCC countries to impose policies that aim to decrease obesity, overweight, and diabetes rates. The objective of this research is to measure the impact of such implemented policy to reduce obesity, namely taxes applied to sugar-sweetened beverages (SSB) in GCC. Methods: The impact of SSB taxes has been measured using a panel data set that covers sales volumes of soft drinks in GCC countries from 2010 to 2020. Results: annual growth in soft drink sales volumes decreased; from 5.44% to 1.33% in Saudi Arabia, 7.37% to 5.93% in United Arab Emirates, and 5.25% to 5.09% in Bahrain from 2016 to 2017. In Qatar, a tax was implemented in 2019, and a reduction in sales volume growth was observed between 2019 and 2020 (3.78% to 2.45%), and in Oman a reduction was observed between 2018 and 2019 (3.60% to 2.99%). Kuwait was the last GCC country to implement taxes in 2020, and the growth in sales volumes decreased from 6.31% to 5.47% from 2019 to 2020. Conclusions: The introduction of health-related taxes on soft drinks has been followed by a drop in the growth rates of sales in GCC countries. This, in turn, can be expected to contribute to a reduction in the prevalence of overweight and obesity, especially when combined with complementary public health policies and interventions. Hence, awareness campaigns should promote the reduction of the consumption sales of SSB and substitute with more consumption of fresh juices. These recommendations align with the recommended priority actions by the World Health Organization Strategy on nutrition for the Eastern Mediterranean Region 2020-2030 adopted by the countries of the Region in October 2019.


Pathogens ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 503
Author(s):  
Ali Rostami ◽  
Seyed Mohammad Riahi ◽  
Vahid Fallah Omrani ◽  
Tao Wang ◽  
Andreas Hofmann ◽  
...  

Toxascaris leonina is an ascaridoid nematode of dogs and cats; this parasite affects the health of these animals. This study estimated the global prevalence of Ta. leonina infection in dogs and cats using random effects meta-analysis as well as subgroup, meta-regression and heterogeneity analyses. The data were stratified according to geographical region, the type of dogs and cats and environmental variables. A quantitative analysis of 135 published studies, involving 119,317 dogs and 25,364 cats, estimated prevalence rates of Ta. leonina in dogs and cats at 2.9% and 3.4%, respectively. Prevalence was highest in the Eastern Mediterranean region (7.2% for dogs and 10.0% for cats) and was significantly higher in stray dogs (7.0% vs. 1.5%) and stray cats (7.5% vs. 1.8%) than in pets. The findings indicate that, worldwide, ~26 million dogs and ~23 million cats are infected with Ta. leonina; these animals would shed substantial numbers of Ta. leonina eggs into the environment each year and might represent reservoirs of infection to other accidental or paratenic hosts. It is important that populations of dogs and cats as well as other canids and felids be monitored and dewormed for Ta. leonina and (other) zoonotic helminths.


2019 ◽  
Vol 26 (1) ◽  
pp. 1-6
Author(s):  
Nagwa Nashat ◽  
Redouane Hadjij ◽  
Abdul Munem Al Dabbagh ◽  
Mohammed Rasoul Tarawneh ◽  
Huda Alduwaisan ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document