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Multimethodology applied to the evaluation of Healthcare in Brazilian municipalities

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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.

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Acknowledgements

We gratefully acknowledge the grants from CNPq (process 304324/2013-2) and FAPERJ/CNE in support of this study.

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Authors and Affiliations

  1. Federal University of the State of Rio de Janeiro, UNIRIO, Centro de Ciências Exatas e Tecnologia, Av Pasteur 458, Rio de Janeiro, RJ, CEP 22290-250, Brazil

    Marcos Pereira Estellita Lins

  2. Faculdade de Engenharia, State University of Rio de Janeiro, Rua São Francisco Xavier 524, 5o andar, Rio de Janeiro, CEP 20550-013, Brazil

    Sergio Orlando Antoun Netto

  3. University Hospital Clementino Fraga Filho, Rua Rodolpho Rocco 255, sala 5a26, Ilha do Fundão, Rio de Janeiro, RJ, CEP 22000-000, Brazil

    Maria Stella de Castro Lobo

Authors
  1. Marcos Pereira Estellita Lins
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  2. Sergio Orlando Antoun Netto
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  3. Maria Stella de Castro Lobo
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Corresponding author

Correspondence to Sergio Orlando Antoun Netto.

Appendix

Appendix

Table 5 Calculation of MHI for municipalities in cluster 3
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Estellita Lins, M.P., Netto, S.O.A. & de Castro Lobo, M.S. Multimethodology applied to the evaluation of Healthcare in Brazilian municipalities. Health Care Manag Sci 22, 197–214 (2019). https://doi.org/10.1007/s10729-018-9432-z

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