Multimethodology applied to the evaluation of Healthcare in Brazilian municipalities

• Published in: Health care management science Vol. 22; no. 2; pp. 197 - 214
• Main Authors: Estellita Lins, Marcos Pereira, Netto, Sergio Orlando Antoun, de Castro Lobo, Maria Stella
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-06-2019; Springer Nature B.V
• Subjects: Brazil; Business and Management; Cities; Data envelopment analysis; Data Interpretation, Statistical; Data mining; Data Mining - methods; Econometrics; Efficiency, Organizational; Health Administration; Health care management; Health care policy; Health Informatics; Health Policy; Humans; Management; Methods; Mixed methods research; Municipalities; Operations Research/Decision Theory; Public Health Administration; Qualitative Research; Quality Assurance, Health Care - methods; Brazil; Cities; Data envelopment analysis (DEA); Concept map; Multimethodology; Data mining; Public health
• ISSN: 1386-9620; 1572-9389
• DOI: 10.1007/s10729-018-9432-z

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.