Factors Influencing Prioritization of Hospital Services for Outsourcing: A Fuzzy Analytic Hierarchy Process Ranking Model

Background and Objectives: Prioritizing the services to be outsourced is a crucial challenge toward efficient outsourcing of health services. In spite of fruitful efforts in improving the outsourcing process, there still remains room and need for developing more systematic approaches. The present paper introduces a novel multi-criteria decision making model based on the fuzzy analytic hierarchy process to determine and prioritize factors highly affecting outsourcing of services in the hospital setting. Methods: By reviewing the literature we identified 23 factors affecting selection of services to be outsourced. Out of these factors, the 17 most relevant were selected based on expert opinion, and grouped into 4 high-level domains, namely strategic/management, structural/organizational, supply/environmental, and service characteristics. A hierarchical model of the identified factors was developed and utilized to design dual comparative matrices. The collected data were analyzed and evaluated by a fuzzy hierarchical analysis approach and the weight and relative priority of each factor was determined Findings: Cost, presence of skilled manpower, and existence of necessary substructures were identified as the highest priority considerations in outsourcing hospital services. Conclusions: The introduced model may be used as a decision support system to enhance the robustness of prioritization when embarking upon outsourcing in the health care services setting.