Abstract

Research is performed in order to assess the applicability of a multi-criteria decision analysis (MCDA) approach for additional evaluation of the health care system efficiency. To achieve the objectives of this research, the modified Delphi method was used as an expert method, inviting experts of medical branches and representatives of patients’ organisations. The questionnaire contained five questions, each of them provided initial information and versions of criteria, as well as provided the experts with opportunity to make the additions, and to propose the weights of scores. For data processing and analysis, the methods of economic analysis and statistical analysis are embraced. The health care system can be defined as a multi-level open system. The authors created a three-level performance evaluation model for assessment of the efficiency of a health care organisation, based on macro-level evaluation (policy impact assessment), meso-level evaluation (system analysis, functional and economic efficiency measuring) and micro-level evaluation (production function, allocative and technical efficiency measures, market analysis). For each of the levels experts provided the weighted scores of criteria which can improve the efficiency measuring of the health care system performance. Taking into account the circumstances of limited state budget resources for health care, the MCDA provides additional opportunities to setting the priorities, based, for instance, on evaluation of the budget allocated diseases’ impact on life expectancy, ability to work, and quality of life. According to the experts’ judgments the group of diagnoses “Neoplasms” gives the greatest common impact on life expectancy, ability to work, and quality of life, followed by the “Diseases of the circulatory system” and “Diseases of the blood and blood forming organs and certain disorders involving the immune mechanisms”. MCDA approach can be used for setting priorities and additional evaluation of the health care system efficiency at each level of its performance.

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