Quality assessment of the Portuguese public hospitals: A multiple criteria approach. (December 2021)

• Record Type: Journal Article
• Authors: Rocha, António; Costa, Ana Sara; Figueira, José Rui; Ferreira, Diogo Cunha; Marques, Rui Cunha
• Is Part Of: Omega. Volume 105(2021)
• Publication Date: 2021-12
• Subjects: Quality -- Hospitals -- National health service -- Electre tri-nc -- Multiple criteria -- Decision analysis -- Multidimensional scales; Management -- Periodicals; 658.4005
• DOI: 10.1016/j.omega.2021.102505
• Languages: English
• ISSNs: 0305-0483

Abstract

Highlights: Quality assessment of the Portuguese public hospitals. Application of a multiple criteria decision aiding approach. Construction of multidimensional criteria' scales using the ELECTRE TRI-C method. Relevant implications for healthcare policy and hospital funding. Abstract: The Portuguese National Health Service (SNS) was created to provide universal, equal, and tendentiously free care. There are different levels of care (primary, secondary, continued, and palliative) and all of them should deliver quality care services. Quality in healthcare is assessed according to several criteria, such as patient safety, care appropriateness or access. However, over the last years political and economic events have had an impact on the SNS. Hence, structural reforms have occurred, and new healthcare policies have been implemented, mostly focused on improving efficiency and reducing costs. It associated to divestment can increment barriers to access, compromise infrastructures and equipment, and, above all, the service's quality. This work aims to assess quality of the Portuguese public hospitals (secondary care providers) in this line. To this aim, we adopt a multiple criteria decision aiding approach, applying the Electre Tri-nC method to build a decision model with intervention of an expert, who acts as the decision maker. Hospitals are assessed and assigned to predefined categories, taking into account the hospitals' performances on various criteria. Each criterion is characterized by different subcriteria, resulting in a complex criteria tree. Thus, to construct a multidimensional scale for each criterion, we propose an innovative approach using an Electre Tri -based method. The results are analyzed and the robustness of the model is tested. This work's findings may have potential application to healthcare policy and hospital funding in the SNS, in which financial sustainability is a permanent challenge.