Multiple Criteria Decision Support for Achieving Sustainable Healthcare System

Chen Binying

Abstract

There has been an increasing gap between rising demand for healthcare services, particularly due to an aging population across the globe, and the limited capacity available for healthcare institutes to accommodate this rising demand. While various researchers have attempted to develop models to evaluate how sustainable healthcare institutions are, these models either over-emphasise some aspects and neglect others, or often lack considerations of an effective post-evaluation methodology to propose efficient improvement plans when sustainability of the healthcare system evaluated is deemed insufficient. Thus, this paper seeks to fill the gap by: (1) designing a comprehensive evaluation framework using Analytic Hierarchy Process (AHP) framework to evaluate healthcare systems holistically and (2) integrating the AHP evaluation framework and a post-evaluation improvement methodology using the Linear Programming (LP) tool. This generates a two-step multiple criteria decision support (MCDS) model that can carry out a holistic assessment and enhancement analysis for any healthcare system or institution of interest, and can be easily extended to evaluating and improving other industrial systems with its high level of flexibility. To illustrate the application of this MCDS model, a case study that involves the comparison of the national healthcare systems of the Singapore and the United States are also presented. In general, the analysis demonstrates the need for improving multiple aspects of a healthcare system simultaneously for effective enhancement, and significant investments from policy makers are required for the healthcare system of interest to be improved effectively. Finally, an efficient frontier of investment is also constructed to demonstrate the behaviour of diminishing returns of sustainability improvement with higher levels of investment.