The DEMATEL method explores the interdependent relationship structure and weights for diagnosis-related groups system

Abstract

PurposeThis study constructs a structure of interaction between dimensions and criteria within the diagnosis-related groups (DRGs) system from a quantitative system and identifies key factors affecting the overall performance of medical services.MethodFrom September to December 2020, the influence relation structure diagram (IRSD) of the dimensions and corresponding criteria was developed from the practical experience of a group of domain experts, based on the DEMATEL method. Subsequently, all dimensions and criteria construct influential weights from a systems perspective. Finally, the main influential factors were identified based on the analysis results.ResultsThe IRSD results showed that, in the overall performance of medical services, “Medical service capacity (C1)” was the main influential dimension, influencing both “Medical service efficiency (C2)” and “Medical service safety (C3).” At the criteria level, “Case-mix index (CMI) (C12),” “Time efficiency index (C21),” and “Inpatient mortality of medium-to-low group (C32)” were the main influential criteria in the corresponding dimensions. The influential weight results showed that “Medical service capacity (C1)” was also a key dimension. “Case-mix index (CMI) (C12),” “Cost efficiency index (C22),” and “Inpatient mortality of medium-to-low group (C32)” were the key criteria in their respective dimensions.ConclusionPatients and managers should first focus on the capacity of medical service providers when making a choice or deciding using the results of the DRGs system. Furthermore, they should pay more attention to medical safety even if it is not as weighted as medical efficiency.

Improve the satisfaction of medical staff on the use of home nursing mobile APP by using a hybrid multi-standard decision model

“…It simplifies the structure of multifactorial systems and identifies key influencing factors [ 30 , 31 ]. Based on graph theory, DEMATEL supports the development of knowledge and experience by analyzing the logical correlations and direct influence relationships between factors in complex systems, revealing key factors [ 32 ]. Due to its universal and simple mechanism, DEMATEL has attracted the attention of many scholars across various disciplines, including environmental science, management, engineering, medicine, and nursing [ 33 – 37 ].…”

“…Due to its universal and simple mechanism, DEMATEL has attracted the attention of many scholars across various disciplines, including environmental science, management, engineering, medicine, and nursing [ 33 – 37 ]. While detailed information regarding the DEMATEL method can be found in related sources [ 32 , 33 , 37 , 38 ], the brief calculation steps are as follows:…”

Identifying key mental health and improvement factors in hospital administrators working from home using a DEMATEL-based network analysis model

“…The influence relationship structure diagram can help decision-makers understand the interaction between all factors ( 18 ). The influence weights can help decision-makers identify key factors in the system ( 19 ).…”

Identification of critical quality factors and critical satisfaction gaps in emergency training courses for new nurses by the multi-criteria network structure model

“…Additionally, MCDM helps experts and managers balance and weigh factors to simplify their decision-making process [ 12 , 13 ]. MCDM has also been widely used in decision-making problems in the medical and nursing fields, such as hospital performance [ 14 ], clinical decision-making [ 15 ], shared decision-making [ 16 , 17 ], and nurses’ job satisfaction [ 9 , 18 ]. The MCDM method is advantageous because it is based on the knowledge of experts.…”