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On the choice of public or private management models in the Brazilian Unified Health System (SUS)

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  • Cuoghi, Kaio Guilherme
  • Leoneti, Alexandre Bevilacqua
  • Passador, João Luiz

Abstract

Different research studies about healthcare organizations in the public and private sectors display several opposite values. Therefore, there are several gaps that make consensual generalizations over the best management model as the only choice for the entire sector unlikely. Considering the importance and complexity of the Brazilian Unified Health System – SUS, the objective of this research study is to propose a framework to aid the choice between public and/or private management models for SUS using a benchmarking of multicriteria methods. Fuzzy TOPSIS, Fuzzy VIKOR, and a group method based on Game Theory were applied to a group of regional experts with different qualifications and perspectives concerning the management models to be selected as alternatives for the city of Ribeirão Preto. Two decision matrices were constructed for that complex problem, one for Primary Care and another for Secondary Care, considering criteria from four dimensions. The alternatives were assessed through sensibility and robustness analysis. Ranking reversal, the perceptions of experts as decision-makers, and similarities to the reality of the city were also evaluated. It has been demonstrated that the framework shows potential in aiding group decision analysis, involving the public agents of each geographical territory covered by the healthcare management models, to endorse the use of proper methods that promote transparency and the use of scientific arguments.

Suggested Citation

  • Cuoghi, Kaio Guilherme & Leoneti, Alexandre Bevilacqua & Passador, João Luiz, 2022. "On the choice of public or private management models in the Brazilian Unified Health System (SUS)," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    • Handle: RePEc:eee:soceps:v:84:y:2022:i:c:s0038012122002233
    DOI: 10.1016/j.seps.2022.101422
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    as
    1. Ferreira, D.C. & Marques, R.C., 2021. "Public-private partnerships in health care services: Do they outperform public hospitals regarding quality and access? Evidence from Portugal," Socio-Economic Planning Sciences, Elsevier, vol. 73(C).
    2. Florien M. Kruse & Niek W. Stadhouders & Eddy M. Adang & Stef Groenewoud & Patrick P.T. Jeurissen, 2018. "Do private hospitals outperform public hospitals regarding efficiency, accessibility, and quality of care in the European Union? A literature review," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(2), pages 434-453, April.
    3. Mónica D. Oliveira & Inês Mataloto & Panos Kanavos, 2019. "Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 891-918, August.
    4. Durbach, Ian N. & Stewart, Theodor J., 2012. "Modeling uncertainty in multi-criteria decision analysis," European Journal of Operational Research, Elsevier, vol. 223(1), pages 1-14.
    5. A. S. Albahri & Jameel R. Al-Obaidi & A. A. Zaidan & O. S. Albahri & Rula A. Hamid & B. B. Zaidan & A. H. Alamoodi & M. Hashim, 2020. "Multi-Biological Laboratory Examination Framework for the Prioritization of Patients with COVID-19 Based on Integrated AHP and Group VIKOR Methods," International Journal of Information Technology & Decision Making (IJITDM), World Scientific Publishing Co. Pte. Ltd., vol. 19(05), pages 1247-1269, August.
    6. Laurence S. J. Roope & John Buckell & Frauke Becker & Paolo Candio & Mara Violato & Jody L. Sindelar & Adrian Barnett & Raymond Duch & Philip M. Clarke, 2020. "How Should a Safe and Effective COVID-19 Vaccine be Allocated? Health Economists Need to be Ready to Take the Baton," PharmacoEconomics - Open, Springer, vol. 4(4), pages 557-561, December.
    7. Ralph L. Keeney & Robin S. Gregory, 2005. "Selecting Attributes to Measure the Achievement of Objectives," Operations Research, INFORMS, vol. 53(1), pages 1-11, February.
    8. F. Hutton Barron & Bruce E. Barrett, 1996. "Decision Quality Using Ranked Attribute Weights," Management Science, INFORMS, vol. 42(11), pages 1515-1523, November.
    9. Rajak, Manindra & Shaw, Krishnendu, 2019. "Evaluation and selection of mobile health (mHealth) applications using AHP and fuzzy TOPSIS," Technology in Society, Elsevier, vol. 59(C).
    10. Scholten, Lisa & Schuwirth, Nele & Reichert, Peter & Lienert, Judit, 2015. "Tackling uncertainty in multi-criteria decision analysis – An application to water supply infrastructure planning," European Journal of Operational Research, Elsevier, vol. 242(1), pages 243-260.
    11. Kevin Marsh & Tereza Lanitis & David Neasham & Panagiotis Orfanos & Jaime Caro, 2014. "Assessing the Value of Healthcare Interventions Using Multi-Criteria Decision Analysis: A Review of the Literature," PharmacoEconomics, Springer, vol. 32(4), pages 345-365, April.
    12. Laura Botega & Mônica Viegas Andrade & Gilvan Ramalho Guedes, 2020. "Brazilian hospitals’ performance: an assessment of the unified health system (SUS)," Health Care Management Science, Springer, vol. 23(3), pages 443-452, September.
    13. Sanjay Basu & Jason Andrews & Sandeep Kishore & Rajesh Panjabi & David Stuckler, 2012. "Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review," PLOS Medicine, Public Library of Science, vol. 9(6), pages 1-14, June.
    14. Sano, Hironobu & Abrucio, Fernando Luiz, 2008. "Promessas e resultados da nova gestão pública no Brasil: o caso das organizações sociais de saúde em São Paulo," RAE - Revista de Administração de Empresas, FGV-EAESP Escola de Administração de Empresas de São Paulo (Brazil), vol. 48(3), July.
    15. Opricovic, Serafim & Tzeng, Gwo-Hshiung, 2004. "Compromise solution by MCDM methods: A comparative analysis of VIKOR and TOPSIS," European Journal of Operational Research, Elsevier, vol. 156(2), pages 445-455, July.
    16. Leoneti, Alexandre Bevilacqua, 2016. "Utility Function for modeling Group Multicriteria Decision Making problems as games," Operations Research Perspectives, Elsevier, vol. 3(C), pages 21-26.
    17. Theodor J Stewart, 2005. "Dealing with Uncertainties in MCDA," International Series in Operations Research & Management Science, in: Multiple Criteria Decision Analysis: State of the Art Surveys, chapter 0, pages 445-466, Springer.
    18. Wang, Xiaoting & Triantaphyllou, Evangelos, 2008. "Ranking irregularities when evaluating alternatives by using some ELECTRE methods," Omega, Elsevier, vol. 36(1), pages 45-63, February.
    19. George A. Boyne, 2002. "Public and Private Management: What’s the Difference?," Journal of Management Studies, Wiley Blackwell, vol. 39(1), pages 97-122, January.
    20. Felipe Costa Araujo & Alexandre Bevilacqua Leoneti, 2020. "Evaluating the Stability of the Oil and Gas Exploration and Production Regulatory Framework in Brazil," Group Decision and Negotiation, Springer, vol. 29(1), pages 143-156, February.
    21. Cuoghi, Kaio Guilherme & Leoneti, Alexandre Bevilacqua, 2019. "A group MCDA method for aiding decision-making of complex problems in public sector: The case of Belo Monte Dam," Socio-Economic Planning Sciences, Elsevier, vol. 68(C).
    22. Edmundas Kazimieras Zavadskas & Abbas Mardani & Zenonas Turskis & Ahmad Jusoh & Khalil MD Nor, 2016. "Development of TOPSIS Method to Solve Complicated Decision-Making Problems — An Overview on Developments from 2000 to 2015," International Journal of Information Technology & Decision Making (IJITDM), World Scientific Publishing Co. Pte. Ltd., vol. 15(03), pages 645-682, May.
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