Multimethodology applied to the evaluation of Healthcare in Brazilian municipalities

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.

A Implementação De Técnicas De Mineração De Dados Na Área De Controle Externo Das Contas Públicas

“…Na mesma área da saúde, Lins et al (2019) se utilizam da multi metodologia que considera que o foco está em um problema complexo do mundo real. Portanto, é necessária uma combinação de métodos quantitativos e qualitativos, para enfrentar as várias naturezas do problema.…”

Planning feasible and efficient operational scenarios for a university hospital through multimethodology

“…Several multimethodological approaches can be applied in the healthcare sector, many of which support systematic government planning. This is the case with the workforce planning in the British National Health System, which combines qualitative and quantitative system dynamics approaches according to stakeholders’ perspectives and demands [ 25 ], and the efficiency analysis in Brazilian municipalities, which combines concept maps and to support the National Public Health System ( World Bank Group, 2017 ; [ 26 ]. Multimethodology has already been applied to Brazilian university hospitals [ 27 ].…”

A Multi-Criteria Approach to Assess the Performance of the Brazilian Unified Health System

“…The construction of the SUS in the last three decades has been unique in Latin America [ 26 ] and is currently considered a model for the rest of the world [ 27 , 28 ]. Its origin lies in the Brazilian Federal Constitution of 1988, which stipulates that health is the responsibility of the government and that every citizen has the right to free and comprehensive healthcare [ 27 , 28 , 29 ]. In this system, services are decentralized and hierarchically organized, with municipalities performing a central role, according to the principles of universality, all-encompassing care, and equal access [ 10 , 30 ].…”