One for all? Assessing the quality of Italian hospital care with the “benefit of the doubt” composite indicator methods

• Published in: Health economics review Vol. 14; no. 1; pp. 83 - 17
• Main Authors: Vidoli, Francesco, Pignataro, Giacomo, Battiato, Sebastiano, Guarnera, Francesco, Guccio, Calogero
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 04-10-2024; Springer Nature B.V; BMC
• Subjects: COVID-19; Data envelopment analysis; Health Care Management; Health Economics; Health Services Research; Hospitalization; Medicine; Medicine & Public Health; Methods; Pandemics; Pharmacoeconomics and Health Outcomes; Public Finance; Public Health; Composite indicator; I18; C44; C43; Benefit of the doubt; Italian NHS; C14; Quality of healthcare
• ISSN: 2191-1991; 2191-1991
• DOI: 10.1186/s13561-024-00559-7

Quality assessment in healthcare systems is challenging due to the multidimensional nature of healthcare services. This study evaluates the overall quality provided by hospitals using composite indicators under the Benefit of the Doubt (BoD) approach, which determines the weights of the indicators with minimal assumptions. We used data from 2015-2020 for Italian Local Health Authorities (LHAs) for 21 outcome measures, applying various non-parametric methods to address aggregation and weighting challenges. Our results show that the BoD measures are robust and effectively capture the dynamics of the quality of LHA, even during external shocks such as the COVID-19 pandemic. This research highlights the importance of methodological choices in the construction of composite indicators and demonstrates the effectiveness of the BoD approach in providing a comprehensive measure of healthcare quality.