Πολυκριτηριακή ανάλυση αποφάσεων για την κατανομή των πόρων και την ιεράρχηση προτεραιοτήτων στα συστήματα υγείας
Multi-criteria decision analysis for resource allocation and priority setting in health systems
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Keywords
Πολυκριτηριακή ανάλυση αποφάσεων ; Kατανομή πόρων ; Iεράρχηση προτεραιοτήτων ; Oικονομικά της υγείας ; Delphi ; MAVT ; Σύστημα υγείας ; Ελλάδα ; Multi-criteria decision analysis ; Resource allocation ; Priority setting ; Health economics ; Health system ; GreeceAbstract
The allocation of limited resources in health systems constitutes a complex decision-making problem, as it requires the consideration of health, economic, social, and organizational parameters. The aim of this dissertation is to develop a systematic and evidence-informed framework for priority setting and resource allocation at the macro level, with application to the Health Care Functions (HC1-HC7) of the System of Health Accounts in the Greek health system. The research is structured in three consecutive empirical stages. First, a comparative analysis of the functional distribution of health expenditure across European Union countries is conducted using Eurostat data for 2023, and distinct patterns of resource allocation are identified through hierarchical cluster analysis. Second, Multi-Criteria Decision Analysis, based on Multi-Attribute Value Theory and the Weighted Sum Model, is applied in combination with a modified three-round Delphi process to validate and weight the criteria and to evaluate the Health Care Functions. Finally, the results are combined with the empirical European benchmark to formulate a proposed target allocation and to simulate ten-year convergence scenarios. The final ranking identifies prevention (HC6) as the highest priority, followed by outpatient and home-based curative care (HC1.3-4), pharmaceutical products (HC5.1), and rehabilitative care (HC2), with statistically significant differences across functions. The proposed target allocation indicates, on the one hand, a substantial reduction in the relative dependence on inpatient curative care and pharmaceutical expenditure and, on the other, a strengthening of outpatient care, rehabilitation, and long-term care. The simulation scenarios indicate that this transition requires a parallel increase in public financing, with a target of 6.5% of GDP, as well as a gradual restructuring of the public-private financing mix. The introduction of a constraint on reductions in pharmaceutical expenditure further highlights the opportunity cost generated by implementation constraints. The dissertation integrates empirical comparative analysis, expert preferences, and policy simulation within a single decision-support framework. The findings support a transition of the Greek health system towards a less hospital-centred model, with greater emphasis on prevention, primary and outpatient care, rehabilitation, and long-term care, without treating the proposed allocation as an absolute or mechanically determined optimal solution.
Department
Σχολή Οικονομικών, Επιχειρηματικών και Διεθνών Σπουδών. Τμήμα Οικονομικής ΕπιστήμηςNumber of pages
234Language
GreekCollections
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Αναφορά Δημιουργού-Μη Εμπορική Χρήση-Όχι Παράγωγα Έργα 3.0 Ελλάδα
Αναφορά Δημιουργού-Μη Εμπορική Χρήση-Όχι Παράγωγα Έργα 3.0 Ελλάδα