Assessing Surgical Performance in Healthcare Institutions using Fuzzy Composite Programming

This paper applies fuzzy composite programming (FCP), which is a multiple criteria decision making (MCDM) model, to comprehensively assess the surgical performance of 6 hospitals. FCP allows the integration of qualitative and quantitative data and provides a better decision model for assessing complex scenarios like surgical outcomes in a hospital setting. The hierarchical fuzzy model is built based on Donnabedian´s model of the quality of medical care, which measures the contribution of structures, processes and outcomes of care. The model is extended by adding a qualitative measure of the patient´s perceived treatment experience using patient survey data. By fitting the FCP model using the quantitative data from measurements of the surgical cases, it was found that structures of care plays the most important role in assessing the surgical performance compared to the other second level indicators - processes of care and outcomes of care. Among third level indicators in the structures of care, wait time prior to surgery was the largest contributor to the structures of care indicator.