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hSNS publication in Omega – The International Journal of Management Science

Quality assessment of the Portuguese public hospitals: A multiple criteria approach

Authors: António Rocha; Ana Sara Costa; José Rui Figueira; Diogo Cunha Ferreira; Rui Cunha Marques


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.


Keywords: Quality; Hospitals; National Health Service; Electre Tri-nC; Multiple criteria Decision Analysis; Multidimensional scales


[Bibliographic reference] Rocha, A.; Costa, A. S.; Figueira, J. R.; Ferreira, D. C.; and Marques, R. C. (2021). Quality assessment of the Portuguese public hospitals: A multiple criteria approach. Omega. https://doi.org/10.1016/j.omega.2021.102505


About the journal: Omega reports on developments in management, including the latest research results and applications. Original contributions and review articles describe the state of the art in specific fields or functions of management, while there are shorter critical assessments of particular management techniques. Other features of the journal are the “Memoranda” section for short communications and “Feedback”, a correspondence column. Omega is both stimulating reading and an important source for practising managers, specialists in management services, operational research workers and management scientists, management consultants, academics, students and research personnel throughout the world. The material published is of high quality and relevance, written in a manner which makes it accessible to all of this wide-ranging readership. Preference will be given to papers with implications to the practice of management. Submissions of purely theoretical papers are discouraged. The review of material for publication in the journal reflects this aim.