en Public Administration & Health management and economics Public Administration & Health management and economics Original Research Original Research <p dir="ltr" style="text-align: justify"><strong>Background: </strong>Due to the increasing health care costs, the issue of productivity in hospitals must be taken into great consideration in order to provide, preserve and promote public health services. Thus, increasing the level of productivity must become the main aim of any hospital. Objective of this study is to determine the total factor productivity and its components over the period under the study.</p> <p dir="ltr" style="text-align: justify"><strong>Methods</strong>: In this cross sectional study, total factor productivity changes of hospitals affiliated to Tehran University of Medical Sciences were measured according to Malmquist index over the period 2009-2014. To estimate total productivity changes using Data Envelopment Analysis method, input-oriented and variable return to scale assumptions were applied and Deap2.1 software was used.</p> <p dir="ltr" style="text-align: justify"><strong>Results</strong>: The mean value of total productivity changes was 1.013. It means that during the study period the productivity experienced a 1.3% decrease. Technological efficiency changes have the greatest influence on productivity decrease than the other factors. Scale efficiency, managerial efficiency and technical efficiency changes were ranked.</p> <p dir="ltr" style="text-align: justify"><strong>Conclusion</strong>: Lack of knowledge of hospital personnel on proper application of technology in patient treatment is the main factor leading to productivity decrease resulting from technological changes in the studied hospitals. Therefore, holding courses for personnel in order to teach them the proper use of technology in diagnosis and patient care can be helpful.</p> <p></p> Hospital, Productivity, Efficiency, Malmquist index. 36 43 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-946&slc_lang=en&sid=1 Bahram Nabilou bnabil@umsu.ac.ir 200319475328460020282 200319475328460020282 No Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran. Hassan Yusefzadeh hyusefzade2010@gmail.com 200319475328460020283 200319475328460020283 No Department of Public Health, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran. Aziz Rezapour rezapoor_a57@yahoo.com 200319475328460020284 200319475328460020284 No School of Health Management and Information Sciences and Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran. Farbod Ebadi Fard Azar f-ebadi@iums.ac.ir 200319475328460020285 200319475328460020285 No Department of Public Health, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. Parviz Salem Safi p_safi2003@yahoo.com 200319475328460020286 200319475328460020286 No Department of Public Health, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran. Ali Sarabi Asiabar Sarabi.a@iums.ac.ir 200319475328460020287 200319475328460020287 No Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran. Nahal Ahmadzadeh nahalahmadzadeh@yahoo.com 200319475328460020288 200319475328460020288 Yes Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.