Reducing the admission rate of in- patients using a Multiple-Criteria Decision Analysis (MCDM)‎

Document Type : Research Paper


Hasheminejad Kidney Center, Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran


Background and Objective: Despite managerial advances in hospital services, patient admission to ‎hospitals is still one of the problems that in addition to imposing additional treatment costs, ‎consumables and equipment depreciation, wastes time in providing services to New patients and also ‎dissatisfaction of patients and staff. Accordingly, in this study, the effect of each of the factors of ‎patient admission in Hasheminejad hospital has been identified and determined.‎
Methods: In order to achieve the purpose of the study, first the files of 314 patients admitted in 2019-‎‎2020 in this hospital were reviewed and the main reasons for patient admission were extracted. Then, ‎by using fuzzy hierarchical analysis, the effect of each of the identified causes was determined. In the ‎next stage, based on the brainstorming techniques with the presence of 20 experts in this field and ‎also the fish bone technique, the identified causes were identified. In the final stage, based on the ‎opinion of experts and brainstorming technique, executive solutions to reduce patient admission were ‎presented and using the approach of fuzzy hierarchical analysis from the point of view of 3 criteria, ‎cost and time required for implementation and feasibility of implementation. Were prioritized.‎
Results: In this study, 5 main causes of disease recurrence, treatment follow-up, nosocomial ‎infections, cancellation of surgeries, disease complications and medication for patient admission were ‎identified in three treatment groups: urology, nephrology and vascular surgery. Based on the output ‎of the hierarchical analysis approach, it was found that: Nosocomial infections with an effect of 0.285 ‎and follow-up treatment with an effect of 0.229 had the highest effect on patients' return to the ‎hospital, also cancellation of surgery had the least effect compared to other factors. In the referral of ‎patients to the hospital, seven practical solutions were presented. Based on the output of fuzzy ‎hierarchical analysis approach, the solutions for recording and tracking hospital infections with the help ‎of the Internet of Things, the development of specialized nutritional training programs by hospital ‎nutrition experts, with scores of 0.182 and 0.165 had the highest executive priority.‎
Conclusion: The use of strategies proposed in this study to reduce patient admission to the hospital is ‎recommended to senior hospital managers.‎