This paper introduces the Stochastic Multicriteria Acceptability Analysis (SMAA) in order to investigate the evolution of mortality rates in the Italian regions over the period 1990–2013. We propose to explore the overall outcome of health care by a Composite Index of mortality based on the combination of standardized mortality rates for seventeen different diseases. From a methodological standpoint, we propose to overcome the arbitrary nature of the weighting process, by using the SMAA, which is a methodology that allows to rank regions considering the whole set of possible vectors of weights. Moreover, we explore the spatial segregation in health using the multidimensional generalization of the Gini index, and introduce the multidimensional generalization of ANOGI. The unprecedented use of SMAA in evaluating the health sector allows to explore regional multidimensional paths beyond the order of importance given to the single dimensions. Our analysis shows that in the 24 years considered there has been no convergence path in terms of health care outcome in Italy, neither between nor within regions.

Exploring health outcomes by stochastic multicriteria acceptability analysis: An application to Italian regions

Raffaele Lagravinese;
2019-01-01

Abstract

This paper introduces the Stochastic Multicriteria Acceptability Analysis (SMAA) in order to investigate the evolution of mortality rates in the Italian regions over the period 1990–2013. We propose to explore the overall outcome of health care by a Composite Index of mortality based on the combination of standardized mortality rates for seventeen different diseases. From a methodological standpoint, we propose to overcome the arbitrary nature of the weighting process, by using the SMAA, which is a methodology that allows to rank regions considering the whole set of possible vectors of weights. Moreover, we explore the spatial segregation in health using the multidimensional generalization of the Gini index, and introduce the multidimensional generalization of ANOGI. The unprecedented use of SMAA in evaluating the health sector allows to explore regional multidimensional paths beyond the order of importance given to the single dimensions. Our analysis shows that in the 24 years considered there has been no convergence path in terms of health care outcome in Italy, neither between nor within regions.
File in questo prodotto:
File Dimensione Formato  
Pubblicazione 1 lagravinese et al 2019.pdf

Open Access dal 01/06/2020

Tipologia: Documento in Versione Editoriale
Licenza: NON PUBBLICO - Accesso privato/ristretto
Dimensione 1.36 MB
Formato Adobe PDF
1.36 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11586/227310
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 17
  • ???jsp.display-item.citation.isi??? 18
social impact