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A Multi-Criteria Approach to Assess the Performance of the Brazilian Unified Health System

Author

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  • Renan Felinto de Farias Aires

    (Department of Applied Social Sciences, Federal Rural University of the Semi-Arid, Mossoró 59625-900, Brazil)

  • Camila Cristina Rodrigues Salgado

    (Department of Applied Social Sciences, Federal University of Paraíba, Bananeiras 58051-900, Brazil)

Abstract

Brazil’s Unified Health System (SUS) provides universal free access to health services and is considered a model for the rest of the world. One of the tools used by the Brazilian government to assess this system is the Index of Unified Health System Performance (IDSUS). However, this method has a number of limitations, such as disregarding the opinion of healthcare decision makers. Thus, the aim of the present study was to propose a model based on the R-TOPSIS in order to assess the performance of the SUS. Methodologically, the main steps for proposing multi-criteria models were followed, and to validate the model, a real case study with a set of six cities (alternatives) of the state of São Paulo was used. The results provide a clearer picture of the differences in terms of potential and obtained access, as well as the effectiveness of health services in the cities analyzed. Likewise, the proposal of integrating multiple criteria as well as considering healthcare decision makers proved to be decisive for the results obtained, even in comparison with the other approaches. It was concluded that the proposed method provides a robust and adequate analysis of health systems performance.

Suggested Citation

  • Renan Felinto de Farias Aires & Camila Cristina Rodrigues Salgado, 2022. "A Multi-Criteria Approach to Assess the Performance of the Brazilian Unified Health System," IJERPH, MDPI, vol. 19(18), pages 1-13, September.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:18:p:11478-:d:913029
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    1. Adiel Teixeira de Almeida & Cristiano Alexandre Virgínio Cavalcante & Marcelo Hazin Alencar & Rodrigo José Pires Ferreira & Adiel Teixeira de Almeida-Filho & Thalles Vitelli Garcez, 2015. "Multicriteria and Multiobjective Models for Risk, Reliability and Maintenance Decision Analysis," International Series in Operations Research and Management Science, Springer, edition 127, number 978-3-319-17969-8, September.
    2. Macharis, Cathy & Springael, Johan & De Brucker, Klaas & Verbeke, Alain, 2004. "PROMETHEE and AHP: The design of operational synergies in multicriteria analysis.: Strengthening PROMETHEE with ideas of AHP," European Journal of Operational Research, Elsevier, vol. 153(2), pages 307-317, March.
    3. Dantas, Marina Kolland & Oliveira, Lilian Ribeiro de & Ferolla, Luna Marquez & Paschoalotto, Marco Antônio Catussi & Lopes, José Eduardo Ferreira & Passador, João Luiz & Passador, Claudia Souza, 2017. "Cross-sectoral assessment of public policies in health and the environment: Scenario of the municipalities in the state of Sao Paulo," Evaluation and Program Planning, Elsevier, vol. 65(C), pages 30-39.
    4. Roman Vavrek, 2019. "Evaluation of the Impact of Selected Weighting Methods on the Results of the TOPSIS Technique," International Journal of Information Technology & Decision Making (IJITDM), World Scientific Publishing Co. Pte. Ltd., vol. 18(06), pages 1821-1843, November.
    5. Edwards, Ward & Barron, F. Hutton, 1994. "SMARTS and SMARTER: Improved Simple Methods for Multiattribute Utility Measurement," Organizational Behavior and Human Decision Processes, Elsevier, vol. 60(3), pages 306-325, December.
    6. Rize Jing & Tingting Xu & Xiaozhen Lai & Elham Mahmoudi & Hai Fang, 2019. "Technical Efficiency of Public and Private Hospitals in Beijing, China: A Comparative Study," IJERPH, MDPI, vol. 17(1), pages 1-18, December.
    7. Hesham K. Alfares & Salih O. Duffuaa, 2016. "Simulation-Based Evaluation of Criteria Rank-Weighting Methods in Multi-Criteria Decision-Making," International Journal of Information Technology & Decision Making (IJITDM), World Scientific Publishing Co. Pte. Ltd., vol. 15(01), pages 43-61, January.
    8. Maria Cristina Gramani, 2014. "Inter-Regional Performance of the Public Health System in a High-Inequality Country," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-8, January.
    9. Ann Barcomb & Nicolas Jullien & Patrick Meyer & Alexandru-Liviu Olteanu, 2019. "Integrating Managerial Preferences into the Qualitative Multi-Criteria Evaluation of Team Members," International Series in Operations Research & Management Science, in: Sandra Huber & Martin Josef Geiger & Adiel Teixeira de Almeida (ed.), Multiple Criteria Decision Making and Aiding, pages 95-143, Springer.
    10. Patrícia Varela & Gilberto de Martins & Luiz Fávero, 2010. "Production efficiency and financing of public health: an analysis of small municipalities in the state of São Paulo — Brazil," Health Care Management Science, Springer, vol. 13(2), pages 112-123, June.
    11. Cláudia Araújo & Carlos Barros & Peter Wanke, 2014. "Efficiency determinants and capacity issues in Brazilian for-profit hospitals," Health Care Management Science, Springer, vol. 17(2), pages 126-138, June.
    12. Renan Felinto de Farias Aires & Luciano Ferreira & Afranio Galdino de Araujo & Denis Borenstein, 2018. "Student selection in a Brazilian university: using a multi-criteria method," Journal of the Operational Research Society, Taylor & Francis Journals, vol. 69(4), pages 528-540, April.
    13. Mustajoki, Jyri & Hamalainen, Raimo P. & Lindstedt, Mats R.K., 2006. "Using intervals for global sensitivity and worst-case analyses in multiattribute value trees," European Journal of Operational Research, Elsevier, vol. 174(1), pages 278-292, October.
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