Abstract
The primary objective of this study is to develop a hybrid multi-criteria decision-making (MCDM) model to evaluate and compare the organizational health literacy responsiveness (OHLR) level of hospitals. To achieve this goal, the health literacy performance indicators are selected, some potential uses of single and hybrid MCDM and qualitative approaches for structured comparison purposes are illustrated, one more common hybrid approach based on the Fuzzy Analytic Hierarchy Process and fuzzy Delphi method was chosen, developed, and applied. To compare the proposed model with its classical non fuzzy version (Qualitative – AHP), a case study example on the effect of their implementation on a structured comparison decisions is conceded, and the Bland Altman agreement method is applied to compare the results obtained by them. The results present the suitability of the application of both hybrid approaches for solving the problem. It also shows that the application of them leads to a distinctive outcomes. Robust Fuzzy based outcomes, and small agreement interval (< 0.0113) and little average change level in the rates of the hospitals (< 2.08 %) are observed between results acquired by the Fuzzy based approach and those which were defined by the other model. Based on these results, a fuzzy based model was recommended for structured comparison of the OHLR level of hospitals under uncertainty conditions. It supports sustainable planning practices, and helps with improvement and effectively distributes the necessary resources.
Highlights
Providing a healthy life for citizens, enhancing well-being for them, providing timely and reliable delivery of quality healthcare, granting access to quality essential healthcare services, reducing risk and cost of services, and improving health outcomes are considered some of the leading sustainable development targets of countries [1,2,3]
The implication of low health literacy leads to an increase in the economic, social, and health burdens of individuals, societies, and countries, which negatively affects the implementation of a country‘s sustainable development plans in general and the health plans in particular
The proposed model (A) depends on three different procedures that distinguish it from the model (B) that was proposed in study [22]; It relies on the fuzzy hierarchical analysis technique instead of the classical hierarchical analysis technique for the purpose of determining the weights of indicators and criteria; It depends on the fuzzy Delphi technique instead of the qualitative evaluation technique that depends on a five-point Likert scale for assessing literacy practices of hospitals
Summary
Providing a healthy life for citizens, enhancing well-being for them, providing timely and reliable delivery of quality healthcare, granting access to quality essential healthcare services, reducing risk and cost of services, and improving health outcomes are considered some of the leading sustainable development targets of countries [1,2,3]. The existence of unreasonable portions of citizens and patients with restricted health literacy in many developing societies and the adverse effects resulting from the increase and spread of this phenomenon negatively affects the use of healthcare, its costs, and output [10]. It has adverse effects on health status and health service utilization [11]. The health literacy concept is used as a tool to [10]: simplify and understand the health systems, which are often complicated,, improve the service provided; structure services in ways that maximize simplicity of systems and reduce challenges that limit access for services, ensure meeting the necessary health literacy requirements and preferences of all individuals that the healthcare organization serves; and improve patient outcomes and healthcare quality
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