Evaluating the Performance of Inpatient Wards in Hospitals Affiliated with Birjand University of Medical Sciences Using the Pabon-Lasso Model in the Years before and during the COVID-19 Pandemic
Authors: Mahmoodi Asiyeh , Taji Masoomeh , Ayask Fahimeh Arabi 
Published: September 2023

Background: Evaluating the performance of hospitals will increase effectiveness, efficiency, and quality of services provided and improves responding to the customer. Performance indicators are the most widely used tools for measuring the performance of hospitals. The prevalence of Covid-19 pandemic has affected health care systems at various levels with significant implications for health, the economy, and social structures. Therefore, the present study evaluates the performance of inpatient wards of hospitals affiliated with South Khorasan University of Medical Sciences in the years before and during the COVID-19 pandemic.
Methods: The current study was cross-sectional, which was conducted during the years before (2018-2019) and during the outbreak of COVID-19 (2020-2021). The research population included all inpatient departments of hospitals affiliated with Birjand University of Medical Sciences (28 departments). The performance of services was analyzed using data collection form, and through the Pabon Lasso model, the efficiency of the hospital was analyzed.  Excel 2018 was used to draw Paben Lasso diagram, describe the data, and check the process of change. Service performance and change process before and during the COVID-19 pandemic were examined using SPSS22 software and Paired sample t-test statistical test (The significance level was determined at 0.05).
Results: The results of this study showed that in the years before and during the COVID-19 pandemic, the functional ratios of bed occupancy percentage decreased by 29.20 %, the average patient stay increased by 6.90 %, and the annual bed turnover rate decreased by 32.80%. The results of paired sample t-test with a significance level of 0.05 showed that there was a significant relationship regarding the internal wards and CCU (Coronary Care Unit) between 3 functional indicators: bed occupancy percentage, bed turnover rate and average patient stay; there was no significant relationship in the burn ward. After examining the wards of kidney and urinary tract surgery, ear, nose and throat surgery, orthopedics, psychiatry, pediatrics, infectious diseases, general surgery, open heart ICU (Intensive Care Unit), neurosurgery, and cardiovascular surgery, 2 functional indicators of bed occupancy percentage and bed turnover rate, in the ICU ward, the functional index of the percentage of bed occupancy, and in the neonatal wards, the NICU (Neonetal Intensive Care Unit), the average length of patient stay showed a significant relationship. After examining the efficiency of the wards, the number of efficient districts changed from 32.14 to 28.57 %, and the number of inefficient districts changed from 25 to 28.57 %. Moreover, positive changes in the efficiency status of the open heart and neonatal ICU departments and negative changes in the efficiency status of the pediatric, internal, psychiatric, and infectious wards were observed in the target period.
Conclusion: With the arrival of COVID-19 pandemic, service performance and efficiency in hospitals affiliated with South Khorasan province decreased due to limited services to patients. During the years under study, on average, less than one third (30.36%) of hospital wards in the region were efficient, and had good performance; therefore, continuous periodic evaluation is recommended for policy makers to exploit the available resources using the Pabon Lasso model or other models.