Speaker
Description
The sustainability of modern health systems is challenged by rising expenditures, demographic pressures, and the need to maintain equitable access to quality care. Conventional prospective payment models, while aiming to promote efficiency, often fail to formally incorporate non-financial performance dimensions such as quality and access into reimbursement calculations, that may lead to resource misallocation. This study proposes a novel hybrid decision-support framework that integrates performance and technical efficiency to optimise hospital payments. The methodology unfolds in three interconnected steps. (i) First, a multicriteria sorting analysis is conducted using the ELECTRE TRI-C method to categorise hospitals based on their performance, operationalised through criteria measuring quality of care and service access. This step identifies a subset of providers that meet a predefined performance threshold. (ii) Second, a benchmarking analysis is applied to this subset using Data Envelopment Analysis (DEA) models to assess their relative efficiency. (iii) Finally, resorting to the obtained relative efficiency values, the optimal payments are computed, similarly to the best practices payment-based tool. An application to the Portuguese public hospitals demonstrates the framework's operational viability and impact. The results illustrate how the hybrid MCDA-DEA approach enables the identification of an optimal payment structure not only regarding efficiency but also the performance of the providers. This study identified potential cost savings, showing high potential for cost containment while aiming for quality, access, and efficiency improvements.
| Keywords | ELECTRE TRI-nC; Data Envelopment Analysis; Payment optimization; Quality; Access; Efficiency; Hospitals |
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| Participation in the SNSF Early-Stage Researcher Support and Award Scheme | I am submitting a regular presentation and would like to participate in the SNSF Early-Stage Researcher Support and Award Scheme. |