Clinics of Yazd: Efficient or Inefficient?*

Document Type : Original Article

Authors
Mirmohamad Asadi 1
Saied Esfandiary 2
Seyed Habibola Mirghafori 3
Zahra Sadeghi Arani 4
1 PhD Student, Management, School of Management, University of Tarbiyat Moddares, Tehran, Iran
2 Management, School of Management, Yazd Jahad Daneshgahi Higher Education Institute, Yazd, Iran
3 Associate Professor, Management and Accounting, School of Management, University of Yazd, Yazd, Iran
4 PhD Student, Management, School of Management, University of Tehran, Tehran, Iran
Abstract
Introduction: Establishing improvement in every organization requires assessment of organizational
performance, planning and goal-setting to improve the performance. Despite remarkable progresses
occurred in recent years on designing the frameworks and performance evaluation systems, many
organizations still rely on traditional criteria. Therefore, according to the importance of performance
evaluation, it has been tried to combine qualitative and quantitative approaches in evaluation of total
quality management models under the European Foundation for Quality Management (EFQM) excellence
model and mathematical models of data envelopment analysis (DEA); i.e. providing a model regarding
performance evaluation for 27 clinics of Yazd city so as to evaluate the advantages of the both methods
and minimize their disadvantages too.
Methods: The study population of this descriptive study consisted of all the officials, staff and physicians
in clinics of Yazd in 2011. 283 subjects participated in the study and 215 of them completed the
questionnaire. The data collection tool was a standard 50-item EFQM excellence model questionnaire.
The validity of this questionnaire has been proved in many previous studies. Cronbach’s alpha was also
used to determine its reliability (r = 0.89). Data analysis was conducted through SPSS software and DEAP
was also used to determine the organizational efficiency.
Results: Out of the 27 selected clinics, the clinics of Akbari (1.09), Qaemiyeh (1.054), Shahrak-Sanati
(1.04), Azadshahr (1.014), Kasnaviyeh (1.06), Khatamolanbiya (1.41), Fateme-Zahra (1.039), Mottahari
(1.056), Paknezhad (1.03), Shah-Vali (1.016), Sepahepasdaran (1.038), dental clinic (1.043), Nickpoor
(1.11) and Kowsar (1.027) were efficient and the rest were inefficient. Khatmolanbyah (1.41) and
Rahmatabad clinics (0.89) obtained the first and the last rating in efficiency, respectively. In other words,
more than half of the clinics in the city (52%) were efficient.
Conclusion: Through combination of data envelopment analysis and organizational excellence models,
which can constitute a strong performance assessment together, managers of the clinics can make a step
toward realistic assessment of the clinics and therefore improve them. Furthermore, inefficient clinics can
also change the human and financial resources in order to reach an acceptable level of performance.

Keywords

1. Tavana M, Karbassi Yazdi A, Shiri M, Rappaport J. An EFQM-Rembrandt excellence model based on the theory
of displaced ideal. Benchmarking: An International Journal 2011; 18(5): 644-67.
2. Salehzadeh R, Ketabi S. Measuring the Efficiency of Qom Hospitals with Data Envelopment Analysis and
Analytic Hierarchy Process. Health Inf Manage 2011; 8(4): 479-789. [In Persian].
3. Vakani F, Fatmi Z, Naqvi K. Three-level quality assessment of a dental hospital using EFQM. Int J Health Care
Qual Assur 2011; 24(8): 582-91.
4. Pham TL. Efficiency and productivity of hospitals in Vietnam. J Health Organ Manag 2011; 25(2): 195-213.
5. Vernero S, Nabitz U, Bragonzi G, Rebelli A, Molinari R. A two-level EFQM self-assessment in an Italian
hospital. Int J Health Care Qual Assur 2007; 20(2-3): 215-31.
6. Torabi Pour A, Rekab Eslamizadeh S. Self-Assessment Based on EFQM Excellence Model in Ahvaz Selected
Hospitals, Iran. Health Inf Manage 2011; 8(2): 138-46. [In Persian].
7. Conti TA. A history and review of the European Quality Award Model. The TQM Magazine 2007; 19(2): 112-28.
8. Najmi M, Hossini S. Excellence model of European foundation for quality management from idea to action.
Tehran, Iran: Ronas Publication; 2003. p. 98-127. [In Persian].
9. Mirfakhr Aldini SH, Farid D, Sayadi Touranlou H. Use of Efqm in analysis of organizational culture dimensions
(case: Yazd health care institutions). J Shaheed Sadoughi Univ Med Sci 2009; 17(2): 30-42. [In Persian].
10.Maleki MR, Izadi AR. Article Title: Empowerment position in Tehran social security hospitals based on the
organizational excellence model (The EFQM). Payesh 2012; 9(2): 131-6. [In Persian].
11.Gomez JG, Costa MM, Lorente AM. A critical evaluation of the EFQM model. International Journal of Quality
& Reliability Management 2011; 28(5): 484-502.
12. Safari S, Azar A. Assessment of organizational performance based on indicators of quality awards - DEA
approach. Daneshvar Raftar 2004; 11(8): 1-14. [In Persian].
13.Alamtabriz A, Imanipour M. Measuring the Relative Efficiency of Health Care Offered in Hospitals of Shahid
Beheshti University of Medical Sciences Using Data Envelopment Analysis (DEA) Technique. Health Inf
Manage 2011; 8(3): 315-25. [In Persian].
14.Hoseini Nasab SE, Baskha M. Calculation the efficiency of the health sector among the selected Islamic
countries. J Health Adm 2009; 12(36): 9-16. [In Persian].
15. Sajjadi SH, Karami M, Karimi S, Bydram R. Efficiency of educational hospital of Isfahan University of Medical
Sciences - using data envelopment analysis. J Health Adm 2009; 12(36): 39-46. [In Persian].
16. Saber Mahani A, Goudarzi GhR, Holam R, Barouni M, Khakian M. Estimation of technical efficiency of general
hospitals of Kerman University of Medical sciences by data envelopment analysis (DEA) method IN 2007. J
Kerman Univ Med Sci 2010; 17(59): 67. [In Persian].
17.Mehregan MR. Performance evaluation of organizations using quantitative data envelopment analysis. Tehran,
Iran: University of Tehran; 2012. [In Persian].
18. Shahroudi K. The Application of Data Envelopment Analysis Methodology to Improve the Benchmarking Process
in the EFQM Business Model (Case Study: Automotive Indust). Iranian Journal of Optimization 2009; 1: 243-65.
19. Shahroudi K, Alipour HR. Mathematical model to rank companies provider EFQM with context - dependent data
envelopment analysis (case study: Iran auto industry). Australian Journal of Basic and Applied Sciences 2011;
5(7): 295-302.
20. Langroudi M, Jandaghi Gh. Validity examination of EFQM'S results by DEA models. Journal of Applied
Quantitative Methods 2008; 3(3): 207-14.
21.Donnelly M. A radical scoring system for the European Foundation for Quality Management Business Excellence
Model. Managerial Auditing Journal 2000; 15(1-2): 8-11.
Health Information Management
Volume 9, Issue 6
Winter 2012
Pages 919-928