Exploring health outcomes by stochastic multicriteria acceptability analysis: An application to Italian regions

Raffaele Lagravinese, Paolo Liberati and Giuliano Resce ()

European Journal of Operational Research, 2019, vol. 274, issue 3, 1168-1179

Abstract: This paper introduces the Stochastic Multicriteria Acceptability Analysis (SMAA) in order to investigate the evolution of mortality rates in the Italian regions over the period 1990–2013. We propose to explore the overall outcome of health care by a Composite Index of mortality based on the combination of standardized mortality rates for seventeen different diseases. From a methodological standpoint, we propose to overcome the arbitrary nature of the weighting process, by using the SMAA, which is a methodology that allows to rank regions considering the whole set of possible vectors of weights. Moreover, we explore the spatial segregation in health using the multidimensional generalization of the Gini index, and introduce the multidimensional generalization of ANOGI. The unprecedented use of SMAA in evaluating the health sector allows to explore regional multidimensional paths beyond the order of importance given to the single dimensions. Our analysis shows that in the 24 years considered there has been no convergence path in terms of health care outcome in Italy, neither between nor within regions.

Keywords: OR in health services; Stochastic multicriteria acceptability Analysis; Composite indicators; Spatial inequality; ANOGI (search for similar items in EconPapers)
JEL-codes: C44 H75 I14 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (22)

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0377221718309342
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:ejores:v:274:y:2019:i:3:p:1168-1179

DOI: 10.1016/j.ejor.2018.11.009

Access Statistics for this article

European Journal of Operational Research is currently edited by Roman Slowinski, Jesus Artalejo, Jean-Charles. Billaut, Robert Dyson and Lorenzo Peccati

More articles in European Journal of Operational Research from Elsevier
Bibliographic data for series maintained by Catherine Liu ().