IDEAS home Printed from https://ideas.repec.org/a/kap/hcarem/v22y2019i2d10.1007_s10729-018-9432-z.html
   My bibliography  Save this article

Multimethodology applied to the evaluation of Healthcare in Brazilian municipalities

Author

Listed:
  • Marcos Pereira Estellita Lins

    (Federal University of the State of Rio de Janeiro, UNIRIO, Centro de Ciências Exatas e Tecnologia)

  • Sergio Orlando Antoun Netto

    (State University of Rio de Janeiro)

  • Maria Stella Castro Lobo

    (University Hospital Clementino Fraga Filho)

Abstract

The integration of quantitative indicators with qualitative descriptions of context is a noticeable demand from many different scientific disciplines, since it contributes to linking theoretical and practical approaches to problem solving. Amongst them are the problem structuring methods, systems thinking and multimethodology. This work presents a mixed quantitative and qualitative methodological approach to aid formulation and structuring of performance measurement of health care in 5565 Brazilian municipalities. Data mining and data envelopment analysis (DEA) are applied in the context of conceptual mapping, thus shedding light on both quantitative and qualitative factors that influence health performance. Our aim is to propose a methodology for performance indicators to support health care policy making in Brazil, using quantitative indicators. However, the approach does not lose track of the role of important qualitative factors in the attribution of meaning to performance assessments. The methodological and analytical results can strengthen mutual understanding by analysts and stakeholders of the problem at hand. Quantitative results allow inefficient municipalities to understand the causes of their overall efficiency in terms of particular low partial DEA efficiencies combined with high deathrates.

Suggested Citation

  • Marcos Pereira Estellita Lins & Sergio Orlando Antoun Netto & Maria Stella Castro Lobo, 2019. "Multimethodology applied to the evaluation of Healthcare in Brazilian municipalities," Health Care Management Science, Springer, vol. 22(2), pages 197-214, June.
    • Handle: RePEc:kap:hcarem:v:22:y:2019:i:2:d:10.1007_s10729-018-9432-z
    DOI: 10.1007/s10729-018-9432-z
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10729-018-9432-z
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s10729-018-9432-z?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Golany, B & Roll, Y, 1989. "An application procedure for DEA," Omega, Elsevier, vol. 17(3), pages 237-250.
    2. Filipe Amado, Carla Alexandra & Dyson, Robert G., 2008. "On comparing the performance of primary care providers," European Journal of Operational Research, Elsevier, vol. 185(3), pages 915-932, March.
    3. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
    4. Le Menestrel, Marc & Van Wassenhove, Luk N., 2004. "Ethics outside, within, or beyond OR models?," European Journal of Operational Research, Elsevier, vol. 153(2), pages 477-484, March.
    5. Maria Castro Lobo & Yasar Ozcan & Angela Silva & Marcos Lins & Roberto Fiszman, 2010. "Financing reform and productivity change in Brazilian teaching hospitals: Malmquist approach," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 18(2), pages 141-152, June.
    6. Jackson, Mike C., 2001. "Critical systems thinking and practice," European Journal of Operational Research, Elsevier, vol. 128(2), pages 233-244, January.
    7. Bougnol, M.-L. & Dulá, J.H. & Estellita Lins, M.P. & Moreira da Silva, A.C., 2010. "Enhancing standard performance practices with DEA," Omega, Elsevier, vol. 38(1-2), pages 33-45, February.
    8. C A F Amado & R G Dyson, 2009. "Exploring the use of DEA for formative evaluation in primary diabetes care: An application to compare English practices," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(11), pages 1469-1482, November.
    9. Yasar A. Ozcan, 2008. "Health Care Benchmarking and Performance Evaluation," International Series in Operations Research and Management Science, Springer, number 978-0-387-75448-2, September.
    10. H. David Sherman & Joe Zhu, 2006. "Service Productivity Management," Springer Books, Springer, number 978-0-387-33231-4, September.
    11. F. Franceschini & M. Galetto & D. Maisano & L. Mastrogiacomo, 2008. "Properties of performance indicators in operations management," International Journal of Productivity and Performance Management, Emerald Group Publishing Limited, vol. 57(2), pages 137-155, January.
    12. Seiford, Lawrence M. & Zhu, Joe, 2002. "Modeling undesirable factors in efficiency evaluation," European Journal of Operational Research, Elsevier, vol. 142(1), pages 16-20, October.
    13. Mingers, John & Brocklesby, John, 1997. "Multimethodology: Towards a framework for mixing methodologies," Omega, Elsevier, vol. 25(5), pages 489-509, October.
    14. William W. Cooper & Lawrence M. Seiford & Kaoru Tone, 2007. "Data Envelopment Analysis," Springer Books, Springer, edition 0, number 978-0-387-45283-8, September.
    15. Scheel, Holger, 2001. "Undesirable outputs in efficiency valuations," European Journal of Operational Research, Elsevier, vol. 132(2), pages 400-410, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Lobo, Maria Stella de Castro & Estellita Lins, Marcos Pereira & Rodrigues, Henrique de Castro & Soares, Gabriel Martins, 2022. "Planning feasible and efficient operational scenarios for a university hospital through multimethodology," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    2. Wenjing Xu & Seyyed Ahmad Edalatpanah & Ali Sorourkhah, 2023. "Solving the Problem of Reducing the Audiences’ Favor toward an Educational Institution by Using a Combination of Hard and Soft Operations Research Approaches," Mathematics, MDPI, vol. 11(18), pages 1-21, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Sepideh Abolghasem & Mehdi Toloo & Santiago Amézquita, 2019. "Cross-efficiency evaluation in the presence of flexible measures with an application to healthcare systems," Health Care Management Science, Springer, vol. 22(3), pages 512-533, September.
    2. Pereira, Miguel Alves & Camanho, Ana Santos & Figueira, José Rui & Marques, Rui Cunha, 2021. "Incorporating preference information in a range directional composite indicator: The case of Portuguese public hospitals," European Journal of Operational Research, Elsevier, vol. 294(2), pages 633-650.
    3. Toloo, Mehdi & Hančlová, Jana, 2020. "Multi-valued measures in DEA in the presence of undesirable outputs," Omega, Elsevier, vol. 94(C).
    4. Cherchye, Laurens & Rock, Bram De & Walheer, Barnabé, 2015. "Multi-output efficiency with good and bad outputs," European Journal of Operational Research, Elsevier, vol. 240(3), pages 872-881.
    5. Campoli, Jessica Suárez & Alves Júnior, Paulo Nocera & Rossato, Fabrícia Gladys Fernandes da Silva & Rebelatto, Daisy Aparecida do Nascimento, 2020. "The efficiency of Bolsa Familia Program to advance toward the Millennium Development Goals (MDGs): A human development indicator to Brazil," Socio-Economic Planning Sciences, Elsevier, vol. 71(C).
    6. Murat Bilsel & Nurhan Davutyan, 2014. "Hospital efficiency with risk adjusted mortality as undesirable output: the Turkish case," Annals of Operations Research, Springer, vol. 221(1), pages 73-88, October.
    7. Jie Wu & Qingyuan Zhu & Pengzhen Yin & Malin Song, 2017. "Measuring energy and environmental performance for regions in China by using DEA-based Malmquist indices," Operational Research, Springer, vol. 17(3), pages 715-735, October.
    8. Shih-Heng Yu, 2019. "Benchmarking and Performance Evaluation Towards the Sustainable Development of Regions in Taiwan: A Minimum Distance-Based Measure with Undesirable Outputs in Additive DEA," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 144(3), pages 1323-1348, August.
    9. Davutyan, Nurhan & Bilsel, Murat & Tarcan, Menderes, 2015. "Migration, Risk-Adjusted Mortality, Varieties of Congestion and Patient Satisfaction in Turkish Provincial General Hospitals," Data Envelopment Analysis Journal, now publishers, vol. 1(2), pages 135-169, July.
    10. Halkos, George & Petrou, Kleoniki Natalia, 2018. "Assessment of national waste generation in EU Member States’ efficiency," MPRA Paper 84590, University Library of Munich, Germany.
    11. Wu, Jie & Zhu, Qingyuan & Ji, Xiang & Chu, Junfei & Liang, Liang, 2016. "Two-stage network processes with shared resources and resources recovered from undesirable outputs," European Journal of Operational Research, Elsevier, vol. 251(1), pages 182-197.
    12. Cordero, José Manuel & Alonso-Morán, Edurne & Nuño-Solinis, Roberto & Orueta, Juan F. & Arce, Regina Sauto, 2015. "Efficiency assessment of primary care providers: A conditional nonparametric approach," European Journal of Operational Research, Elsevier, vol. 240(1), pages 235-244.
    13. Margit Sommersguter-Reichmann, 2022. "Health care quality in nonparametric efficiency studies: a review," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 30(1), pages 67-131, March.
    14. Ismet Sahin & Yasar Ozcan & Hacer Ozgen, 2011. "Assessment of hospital efficiency under health transformation program in Turkey," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 19(1), pages 19-37, March.
    15. Chang, Dong-Shang & Liu, Wenrong & Yeh, Li-Ting, 2013. "Incorporating the learning effect into data envelopment analysis to measure MSW recycling performance," European Journal of Operational Research, Elsevier, vol. 229(2), pages 496-504.
    16. Zanella, Andreia & Camanho, Ana S. & Dias, Teresa G., 2015. "Undesirable outputs and weighting schemes in composite indicators based on data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 245(2), pages 517-530.
    17. Quintano, Claudio & Mazzocchi, Paolo & Rocca, Antonella, 2021. "Evaluation of the eco-efficiency of territorial districts with seaport economic activities," Utilities Policy, Elsevier, vol. 71(C).
    18. Gómez-Calvet, Roberto & Conesa, David & Gómez-Calvet, Ana Rosa & Tortosa-Ausina, Emili, 2014. "Energy efficiency in the European Union: What can be learned from the joint application of directional distance functions and slacks-based measures?," Applied Energy, Elsevier, vol. 132(C), pages 137-154.
    19. Richard Simper & Maximilian J.B. Hall & Wenbin B. Liu & Valentin Zelenyuk & Zhongbao Zhou, 2014. "How Relevant is the Choice of Risk Management Control Variable to Non-parametric Bank Profit Efficiency Analysis?," CEPA Working Papers Series WP122014, School of Economics, University of Queensland, Australia.
    20. George Fragkiadakis & Michael Doumpos & Constantin Zopounidis & Christophe Germain, 2016. "Operational and economic efficiency analysis of public hospitals in Greece," Post-Print hal-01414677, HAL.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:kap:hcarem:v:22:y:2019:i:2:d:10.1007_s10729-018-9432-z. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.