A decision system using fuzzy cognitive map and multi-group data envelopment analysis to estimate hospitals’ outputs level

Due to its vital role in healthcare system, performance evaluation of hospitals is indispensable. In addition, hospitals try to achieve desired and efficient conditions by careful planning based on their present facilities. Several studies have been conducted on hospital evaluation, but nearly none of them has taken into consideration the difference in the nature of performance in respect of hospitals’ managerial construction, funding, and type of services provided by them. Furthermore, hospitals’ outputs have not been estimated in respect of cause and effect relationships between inputs and outputs for achieving efficient conditions. In the present study, first, a new approach for hospital evaluation is presented according to the differences in the nature of their performances while categorized in groups. Then, optimal outputs for each hospital in its own group are dealt with using results obtained from multi-group data envelopment analysis and the method of fuzzy cognitive map. The activation Hebbian learning (AHL) algorithm is adapted to the concept of efficiency and is conducted to estimate the outputs of inefficient hospitals. In the present study, 27 hospitals located in the provincial capitals in northwest of Iran are categorized in four groups including general governmental hospitals, specialty governmental hospitals, private hospitals, and social security hospitals. Afterward, optimal outputs are estimated for the inefficient hospitals by using the proposed modified AHL algorithm. The results indicate that when the hospitals have been evaluated in groups, efficiency scores of hospitals have changed. Also, given the cause and effect relationships between inputs and outputs in each group can help to decision and policy makers to estimate the optimal outputs that have caused inefficient hospitals become efficient.