The impact of Health Sector Evolution Plan on the performance of hospitals in Iran: Evidence from the Pabon Lasso model

Purpose The Health Sector Evolution Plan (HSEP) is the most recent reform in Iran's health care system that was launched in May 2014 in all university-affiliated hospitals to reduce health care expenditure for patients, while improving the efficiency and quality of hospital services. The purpose of this paper is to evaluate the impact of the HSEP on the performance of 15 hospitals affiliated with Kermanshah University of Medical Sciences (KUMS), located in the western region of Iran. Design/methodology/approach The Pabon Lasso model was used to measure the performance of hospitals before and after the implementation of the HSEP in 2013-2014 and 2015-2016, respectively. Three indicators of average length of stay (ALoS), bed occupancy rate (BOR) and bed turnover rate (BTR) were analyzed by the Pabon Lasso model. Findings The results showed that the average ALoS, BTR and BOR before the introduction of the HSEP were 2.59 days, 92 times and 57 percent, respectively, and the corresponding figures for these indicators after the implementation of the HSEP were 2.61 days, 98.9 times and 59.9 percent. The results indicated that before the introduction of the HESP, 40 percent of hospitals were in zone 1 (poor performance: low BTR and BOR and high ALoS), 27 percent in zone 2, 20 percent in zone 3 (good performance: high BTR and BOR and low ALoS) and 13 percent in zone 4. After the HSEP, the proportion of hospitals in zones 1-4 was 33, 27, 20 and 20 percent, respectively. Originality/value This study is the first to use the Pabon Lasso model technique to evaluate the impact of the HSEP on hospitals affiliated with KUMS