Modelo multicritério de apoio à decisão para ordenação das especialidades médicas mais favoráveis para inserção na rede própria: estudo de caso em uma operadora de planos de saúde do Rio Grande do Norte

• Ano de defesa: 2024
• Autor(a) principal: Maia, Joyce Abreu
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Rio Grande do Norte; Brasil; UFRN; PROGRAMA DE PÓS-GRADUAÇÃO EM ENGENHARIA DE PRODUÇÃO
• Palavras-chave em Português: Saúde suplementar; Escolha de especialidades; Multicritério; FITradeoff; VFT; CNPQ::ENGENHARIAS::ENGENHARIA DE PRODUCAO
• Link de acesso: https://repositorio.ufrn.br/handle/123456789/58023

This research aims to propose a model for selecting specialties that could integrate the proprietary network of a health insurance provider located in the city of Natal, state of Rio Grande do Norte. Private health insurance plans are seen by the population as a complement to the services offered by the Unified Health System (SUS), coexisting with this public service. Although a significant portion of the population accesses private health services, the sector still operates at a deficit, which raises concerns about cost control and revenue generation. One of the strategies adopted for maintaining its services is vertical integration. For a decision with multiple attributes, it is necessary to consider various aspects beyond financial analysis, including the subjectivity of the process in deciding which medical specialties to bring into the proprietary network. In the case of complex health context problems, one of the tools used with considerable acceptance is multi-criteria decision analysis. Considering that decisions in the health sector involve the confrontation of multiple objectives, and knowing that the criteria used in health evaluation have profound ethical implications, decision analysis enables the investigation of these objectives and criteria in light of possible conflicts among multiple stakeholders. For this analysis, a combined use of Value-Focused Thinking with the FITradeoff decision support method is performed to obtain a prioritization of medical specialties suitable for contracting into the proprietary network. The developed model has 05 criteria and 16 alternatives, providing a ranking of specialties that can be contracted for the proprietary network of a provider, from most desirable to least desirable. From the decision maker's perspective, who holds the position of administrative-financial director, the model was considered valid, providing a structured procedure that enables the expression of this decision maker's preferences, contributing to a more efficient decision-making process.