Analyzing the key performance indicators of circular supply chains by hybrid fuzzy cognitive mapping and Fuzzy DEMATEL: evidence from healthcare sector

Asana Hosseini Dolatabad (), Hannan Amoozad Mahdiraji (), Ali Zamani Babgohari (), Jose Arturo Garza-Reyes () and Ahad Ai ()
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Asana Hosseini Dolatabad: University of Tehran
Hannan Amoozad Mahdiraji: University of Leicester
Ali Zamani Babgohari: University of Tehran
Jose Arturo Garza-Reyes: University of Derby
Ahad Ai: Lawrence Technological University

Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, 2025, vol. 27, issue 10, No 6, 23345-23371

Abstract: Abstract This study presents a multi-layer fuzzy-based decision-making approach to enhance the hospital Circular Supply Chain (CSC) performance by focusing on intensive care units (ICU) via key performance indicators analysis. In this regard, a Systematic Literature Review (SLR) and Institution Fuzzy Delphi (IFD) are employed to extract the relevant and prominent KPIs. After, a hybrid Fuzzy Cognitive Mapping (FCM) and Fuzzy Decision Making Trial and Evaluation Laboratory (FDEMATEL) have been applied to illustrate a conceptual framework for the CSC performance management of the healthcare sector in the emerging economy of Iran. As a result, eight critical indicators emanated from the SLR-IFD approach. Furthermore, sixteen relationships amongst the performance indicators were identified via hybrid FCM-FDEMATEL. Inventory availability, information availability, innovation, and technology were selected as the most influential indicators. Besides, changing the information technology category, including information availability and Innovation and technology, had the most impact on the performance of the entire CSC. This study attempts to evaluate hospitals’ circular supply chain performance, by designing the circular evaluation framework. Hospital managers can use the results of this research to improve their internal circular supply chain performances in the intensive care units by understanding the different scenarios.

Keywords: Healthcare performance measurement; Healthcare key performance indicators; Circular supply chain; Fuzzy cognitive map; Fuzzy DEMATEL (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10668-022-02535-9

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