Abstract
BackgroundDecision making in the health area usually involves several factors, options and data. In addition, it should take into account technological, social and spatial aspects, among others. Decision making methodologies need to address this set of information , and there is a small group of them with focus on epidemiological purposes, in particular Spatial Decision Support Systems (SDSS).MethodsMakes uses a Multiple Criteria Decision Making (MCDM) method as a combining rule of results from a set of SDSS, where each one of them analyzes specific aspects of a complex problem. Specifically, each geo-object of the geographic region is processed, according to its own spatial information, by an SDSS using spatial and non-spatial data, inferential statistics and spatial and spatio-temporal analysis, which are then grouped together by a fuzzy rule-based system that will produce a georeferenced map. This means that, each SDSS provides an initial evaluation for each variable of the problem. The results are combined by the weighted linear combination (WLC) as a criterion in a MCDM problem, producing a final decision map about the priority levels for fight against a disease. In fact, the WLC works as a combining rule for those initial evaluations in a weighted manner, more than a MCDM, i.e., it combines those initial evaluations in order to build the final decision map.ResultsAn example of using this new approach with real epidemiological data of tuberculosis in a Brazilian municipality is provided. As a result, the new approach provides a final map with four priority levels: “non-priority”, “non-priority tendency”, “priority tendency” and “priority”, for the fight against diseases.ConclusionThe new approach may help public managers in the planning and direction of health actions, in the reorganization of public services, especially with regard to their levels of priorities.
Highlights
Decision making in a dynamic and rapidly evolving world is a great challenge, since several factors can influence the final decision, such as: the decision maker, conflicts of interest, the importance of the decision, different criteria involved in the problem, among others [1]
Multiple Criteria Decision Making has been applied in areas of knowledge such as: energy, environment and sustainability, supply chain management, material, quality management, geographic information systems, construction and project management, security and risk management, strategic management, knowledge management, production management, tourism management, among others [8]
According to the new classification of the World Health Organization (2016–2020), Brazil ranks 20th in the list of 30 countries with high TB burden and 19th in the list of 30 countries with high tuberculosis–human immunodeficiency virus (HIV) co-infection [46]
Summary
Decision making in a dynamic and rapidly evolving world is a great challenge, since several factors can influence the final decision, such as: the decision maker, conflicts of interest, the importance of the decision, different criteria involved in the problem, among others [1]. Multiple Criteria Decision Making has been applied in areas of knowledge such as: energy, environment and sustainability, supply chain management, material, quality management, geographic information systems, construction and project management, security and risk management, strategic management, knowledge management, production management, tourism management, among others [8]. It has generally been used in the face of complex, uncertain and conflicting situations [9]. Decision making in the health area usually involves several factors, options and data It should take into account technological, social and spatial aspects, among others.
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