A Multi-Criteria Approach to Assess the Performance of the Brazilian Unified Health System

Renan Felinto de Farias Aires () and Camila Cristina Rodrigues Salgado
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Renan Felinto de Farias Aires: Department of Applied Social Sciences, Federal Rural University of the Semi-Arid, Mossoró 59625-900, Brazil
Camila Cristina Rodrigues Salgado: Department of Applied Social Sciences, Federal University of Paraíba, Bananeiras 58051-900, Brazil

IJERPH, 2022, vol. 19, issue 18, 1-13

Abstract: Brazil’s Unified Health System (SUS) provides universal free access to health services and is considered a model for the rest of the world. One of the tools used by the Brazilian government to assess this system is the Index of Unified Health System Performance (IDSUS). However, this method has a number of limitations, such as disregarding the opinion of healthcare decision makers. Thus, the aim of the present study was to propose a model based on the R-TOPSIS in order to assess the performance of the SUS. Methodologically, the main steps for proposing multi-criteria models were followed, and to validate the model, a real case study with a set of six cities (alternatives) of the state of São Paulo was used. The results provide a clearer picture of the differences in terms of potential and obtained access, as well as the effectiveness of health services in the cities analyzed. Likewise, the proposal of integrating multiple criteria as well as considering healthcare decision makers proved to be decisive for the results obtained, even in comparison with the other approaches. It was concluded that the proposed method provides a robust and adequate analysis of health systems performance.

Keywords: health system; unified health system (SUS); index of unified health system performance (IDSUS); performance assessment; multi-criteria decision analysis (MCDA); R-TOPSIS (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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