On Designing Health Care Plans and Systems from the Multiple Criteria Decision Making (MCDM) Perspective

Abstract

Many studies of medical decision making focus on the cost effectiveness of taking action A for disease X. These focused evaluations do not consider that the recommended actions must compete in aggregate for available resources. Relatively fewer studies have considered the aggregate decision making required for the rational design of health care. The operations research perspective and, in particular, the MCDM perspective can aid our understanding of the design of health care plans from the insurer’s and payer’s perspectives. This paper considers issues in defining health benefits plans and suggests how MCDM methodology can assist in structuring the appropriate decision context. Issues to be addressed in designing health plans include global budgets, new technology, system objectives, the hierarchy of decision makers in medical care, and data requirements. While MCDM methods may be useful in health policy making, considering these complex applications can also provide a focus for further conceptual and methodological developments in MCDM.