Integrating Multi-Criteria Decision Analysis in Healthcare Policy and Practice

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Publiée : Dec 31, 2024
DOI : https://doi.org/10.12681/hapscpbs.40780
Alkinoos Emmanouil-Kalos
Laboratory of Health Economics and Management, Department of Economics, University of Piraeus, Greece; Deputy General Director, Hellenic Association of Political Scientists; Vice President, Hellenic Institute of Political Economy.
Résumé

Decision-making in healthcare financing requires balancing diverse and often competing criteria. Multi-Criteria Decision Analysis (MCDA) offers a structured framework for evaluating multiple factors simultaneously, enhancing efficiency, transparency and consistency. This policy brief explores the integration of MCDA in healthcare, detailing its advantages in supporting comprehensive evaluations and succinctly presenting various prominent MCDA models. Moreover, a step-by-step framework for applying MCDA in healthcare decision making is presented, emphasizing stakeholder engagement and criterion selection. Finally, the brief addresses the challenges that accompany MCDA implementation and offers strategies to mitigate these issues.

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Références
Akpan, U., & Morimoto, R. (2022). An application of Multi-Attribute Utility Theory (MAUT) to the prioritization of rural roads to improve rural accessibility in Nigeria. Socio-Economic Planning Sciences, 82, 101256. https://doi.org/10.1016/j.seps.2022.101256
Baltussen, R., Marsh, K., Thokala, P., Diaby, V., Castro, H., Cleemput, I., … & Broekhuizen, H. (2019). Multicriteria decision analysis to support health technology assessment agencies: benefits, limitations, and the way forward. Value in Health, 22(11), 1283-1288. https://doi.org/10.1016/j.jval.2019.06.014
Baran-Kooiker, A., Czech, M., & Kooiker, C. (2018). Multi-criteria decision analysis (mcda) models in health technology assessment of orphan drugs—a systematic literature review. next steps in methodology development?. Frontiers in Public Health, 6. https://doi.org/10.3389/fpubh.2018.00287
Bates, M., Larkin, S., Keisler, J. M., & Linkov, I. (2015). How decision analysis can further nanoinformatics. Beilstein Journal of Nanotechnology, 6, 1594-1600. https://doi.org/10.3762/bjnano.6.162
Corvin, J., Chan, I., Loi, C. X. A., Dollman, I., & Gonzales, J. (2020). Analytic hierarchy process: an innovative technique for culturally tailoring evidence‐based interventions to reduce health disparities. Health Expectations, 24(S1), 70-81. https://doi.org/10.1111/hex.13022
De Montis, A., De Toro, P., Droste-Franke, B., Omann, I., & Stagl, S. (2005). Criteria for quality assessment of MCDA methods. In: Getzener, M., Spash, C., Stagl, S. (Eds). Alternatives for Environmental Valuation. London: Routledge, 99–133.
Devlin, N.J., Sussex, J. (2011). Incorporating multiple criteria in HTA: Methods and Processes. London: Office of Health Economics. https://www.ohe.org/publications/incorporating-multiple-criteria-hta-methods-and-processes/
DiStefano, M. J. and Krubiner, C. (2020). Beyond the numbers: a critique of quantitative multi-criteria decision analysis. International Journal of Technology Assessment in Health Care, 36(4), 292-296. https://doi.org/10.1017/s0266462320000410
Donaldson, C., Currie, G., & Mitton, C. (2002). Cost effectiveness analysis in health care: contraindications. BMJ, 325(7369), 891–894. https://doi.org/10.1136/bmj.325.7369.891
Figueira, J. R., Greco, S., Roy, B., & Słowiński, R. (2013). An overview of ELECTRE methods and their recent extensions. Journal of Multi‐Criteria Decision Analysis, 20(1-2), 61-85.
Frazão, T. D. C., Camilo, D. G. G., Cabral, E. L. d. S., & Souza, R. P. d. (2018). Multicriteria decision analysis (mcda) in health care: a systematic review of the main characteristics and methodological steps. BMC Medical Informatics and Decision Making, 18(1). https://doi.org/10.1186/s12911-018-0663-1
Gäebel, W., Lehmann, I., Chisholm, D., Hinkov, H., Höschl, C., Kapócs, G., … & Zielasek, J. (2020). Quality indicators for mental healthcare in the danube region: results from a pilot feasibility study. European Archives of Psychiatry and Clinical Neuroscience, 271(6), 1017-1025. https://doi.org/10.1007/s00406-020-01124-z
Galo, A. (2017). Analytical Hierarchy Process as a Decision-Making Model. European Journal of Multidisciplinary Studies, 2(2), 106-112. https://doi.org/10.26417/ejms.v4i2.p106-112
Garau, M., Hampson, G., Devlin, N., Mazzanti, N. A., & Profico, A. (2017). Applying a multicriteria decision analysis (mcda) approach to elicit stakeholders’ preferences in italy: the case of obinutuzumab for rituximab-refractory indolent non-hodgkin lymphoma (inhl). PharmacoEconomics - Open, 2(2), 153-163. https://doi.org/10.1007/s41669-017-0048-x
Glaize, A., Duenas, A., Martinelly, C. D., & Fagnot, I. (2019). Healthcare decision‐making applications using multicriteria decision analysis: a scoping review. Journal of Multi-Criteria Decision Analysis, 26(1-2), 62-83. https://doi.org/10.1002/mcda.1659
Goetghebeur, M. and Cellier, M. (2018). Can reflective multicriteria be the new paradigm for healthcare decision-making? the evidem journey. Cost Effectiveness and Resource Allocation, 16(S1). https://doi.org/10.1186/s12962-018-0116-9
Goetghebeur, M., Wagner, M., Khoury, H., Levitt, R. J., Erickson, L. J., & Rindress, D. (2011). Bridging health technology assessment (hta) and efficient health care decision making with multicriteria decision analysis (mcda). Medical Decision Making, 32(2), 376-388. https://doi.org/10.1177/0272989x11416870
Guarga, L., Badia, X., Obach, M., Fontanet, M., Prat, A., Vallano, A., … & Pontes, C. (2019). Implementing reflective multicriteria decision analysis (mcda) to assess orphan drugs value in the catalan health service (catsalut). Orphanet Journal of Rare Diseases, 14(1). https://doi.org/10.1186/s13023-019-1121-6
Hansen, P., & Devlin, N. (2019). Multi-criteria decision analysis (MCDA) in healthcare decision-making. In Oxford research encyclopedia of economics and finance.
Holtorf, A., Kristin, E., Assamawakin, A., Upakdee, N., Indrianti, R., & Apinchonbancha, N. (2021). Case studies for implementing mcda for tender and purchasing decisions in hospitals in indonesia and thailand. Journal of Pharmaceutical Policy and Practice, 14(1). https://doi.org/10.1186/s40545-021-00333-8
Jit, M. (2018). MCDA from a health economics perspective: opportunities and pitfalls of extending economic evaluation to incorporate broader outcomes. Cost Effectiveness and Resource Allocation, 16, S1, 45. https://doi.org/10.1186/s12962-018-0118-7
Klein, R. (2010). Rationing in the fiscal ice age. Health Economics, Policy and Law, 5(4), 389-396.
Kolasa, K., Zah, V., & Kowalczyk, M. (2018). How can multi criteria decision analysis support value assessment of pharmaceuticals? Findings from a systematic literature review. Expert Review of Pharmacoeconomics & Outcomes Research, 18(4), 379–391. https://doi.org/10.1080/14737167.2018.1467759
Le Deunf, J., Khannoussi, A., Lecornu, L., Meyer, P., & Puentes, J. (2024). Data quality assessment through a preference model. ACM Journal of Data and Information Quality, 16(1), 1-21.
Lloyd-Williams, H. (2019). The role of multi-criteria decision analysis (MCDA) in public health economic evaluation. In Edwards, R. T., & McIntosh, E. (Eds). Applied Health Economics for Public Health Practice and Research. Handbooks in Health Economic Evaluation. Oxford Academic. https://doi.org/10.1093/med/9780198737483.003.0013
Madanchian, M. and Taherdoost, H. (2023), “A comprehensive guide to the TOPSIS method for multi-criteria decision making”, Sustainable Social Development, Vol. 1 No. 1, doi: 10.54517/ssd.v1i1.2220.
Makan A, Fadili A. Sustainability assessment of healthcare waste treatment systems using surrogate weights and PROMETHEE method. Waste Management & Research. 2021;39(1):73-82. doi:10.1177/0734242X20947162
Marsh, K., Lanitis, T., Neasham, D., Orfanos, P., & Caro, J. (2014). Assessing the value of healthcare interventions using multi-criteria decision analysis: a review of the literature. Pharmacoeconomics, 32(4), 345-365.
Marttunen, M., Mustajoki, J., Dufva, M., & Karjalainen, T. (2015). How to design and realize participation of stakeholders in MCDA processes? A framework for selecting an appropriate approach. EURO Journal on Decision Processes, 3(1-2), 187-214.
Muñoz, D. A., Nembhard, H. B., & Kraschnewski, J. L. (2014). Quantifying complexity in translational research: an integrated approach. International Journal of Health Care Quality Assurance, 27(8), 760-776. https://doi.org/10.1108/ijhcqa-01-2014-0002
Oliveira, M. D., Mataloto, I., & Kanavos, P. (2019). Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art. The European Journal of Health Economics, 20(6), 891-918. https://doi.org/10.1007/s10198-019-01052-3
Sawik, B. (2015). Weighted-sum approach to health care optimization. In Applications of management science (Vol. 17, pp. 163-180). Emerald Group Publishing Limited.
Schey, C., Krabbe, P. F. M., Postma, M. J., & Connolly, M. P. (2017). Multi-criteria decision analysis (mcda): testing a proposed mcda framework for orphan drugs. Orphanet Journal of Rare Diseases, 12(1). https://doi.org/10.1186/s13023-016-0555-3
Schmidt, K., Aumann, I., Hollander, I., Damm, K., & von der Schulenburg, J. M. G. (2015). Applying the Analytic Hierarchy Process in healthcare research: A systematic literature review and evaluation of reporting. BMC medical informatics and decision making, 15, 1-27. https://doi.org/10.1186/s12911-015-0234-7
Chung, S., Kim, S., Kim, J., & Sohn, K. (2010). Use of multiattribute utility theory for formulary management in a health system. American Journal of Health-System Pharmacy, 67(2), 128-135. https://doi.org/10.2146/ajhp080672
Sparrevik, M., Barton, D. N., Oen, A., Sehkar, N. U., & Linkov, I. (2011). Use of multicriteria involvement processes to enhance transparency and stakeholder participation at bergen harbor, norway. Integrated Environmental Assessment and Management, 7(3), 414-425. https://doi.org/10.1002/ieam.182
Thokala, P., Duenas, A. (2012) Multiple Criteria Decision Analysis for Health Technology Assessment. Value in Health, 15, 1172-1181. http://dx.doi.org/10.1016/j.jval.2012.06.015
Thokala, P., Madhavan, G. (2018). Stakeholder involvement in Multi-Criteria Decision Analysis. Cost Effectiveness and Resource Allocation, 16 (Suppl 1), 1-3. https://doi.org/10.1186/s12962-018-0120-0
Thomas, R., Chalkidou, K. (2016). Cost–effectiveness analysis. In: Cylus. J., Papanicolas, I., Smith, P.C. (Eds). Health system efficiency: How to make measurement matter for policy and management. Health Policy Series, No. 46. European Observatory on Health Systems and Policies. Available from: https://www.ncbi.nlm.nih.gov/books/NBK436886/
Tony, M., Wagner, M., Khoury, H., Rindress, D., Papastavros, T., Oh, P., … & Goetghebeur, M. (2011). Bridging health technology assessment (hta) with multicriteria decision analyses (mcda): field testing of the evidem framework for coverage decisions by a public payer in canada. BMC Health Services Research, 11(1). https://doi.org/10.1186/1472-6963-11-329
Uzun, B., Taiwo, M., Syidanova, A., Uzun Ozsahin, D. (2021). The Technique For Order of Preference by Similarity to Ideal Solution (TOPSIS). In: Uzun Ozsahin, D., Gökçekuş, H., Uzun, B., LaMoreaux, J. (eds) Application of Multi-Criteria Decision Analysis in Environmental and Civil Engineering. Professional Practice in Earth Sciences. Springer, Cham. https://doi.org/10.1007/978-3-030-64765-0_4
Wagner, M., Khoury, H., Willet, J., Rindress, D., & Goetghebeur, M. (2015). Can the evidem framework tackle issues raised by evaluating treatments for rare diseases: analysis of issues and policies, and context-specific adaptation. PharmacoEconomics, 34(3), 285-301. https://doi.org/10.1007/s40273-015-0340-5
Wouterse, B., van Baal, P., Versteegh, M. et al. (2023). The Value of Health in a Cost-Effectiveness Analysis: Theory Versus Practice. PharmacoEconomics, 41, 607–617. https://doi.org/10.1007/s40273-023-01265-8
Xu, S., Wu, X., R, H., Li, H., He, H., Hu, J., … & Liao, X. (2022). Knowledge mapping of multicriteria decision analysis in healthcare: a bibliometric analysis. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.895552
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