BackgroundThe health area is one of the most affected systems on the perspective of decision-making with multiobjectives, thus becoming prone to errors in the final solution, however, multicriteria decision analysis (MDCA) appears as an aid tool for this process decision-making. Therefore,the present study aims to analyze and synthesize articles found in the literature, involing MCDA in health care, evaluating general issues and methodological aspects, structuring them in a single work.MethodsSurveys in the bibliographic databases SCOPUS and PUBMED indicated 1852 documents on the subject, however after a careful verificatios, 66 studies were selected to be analyzed completely. The data extracted from the included articles were organized into a spreadsheet for the preparation of analysis, and the technique used was descriptive statistics.ResultsIt was possible to identify a growth trend in the application of the MCDA in the health area, but no dominance was identified in relation to the authors of the publication and the periodicals where they are published, but some countries stood out in terms of the number of published researches, such as: Canada and Turkey. In defining the decision problem, and in defining criteria, the “literature” presented the greatest demand for those who wish to structure their decision problem. Finally, it was verified by the analysis of the problem, that the MCDA to solve the problems of ranking has comprehensive application and that there is a greater incidence in the use of the AHP and Logic methods Fuzzy.ConclusionWith this, it is possible to observe, through the data of this review, that more than the multicriteria methods, the multicriteria decision model has been highlighted, also in the health area. In addition, the study can guide new applications and techniques using MCDA in the health care.

Background: Multiobjective decision-making processes present a high degree of complexity in their solution, and tools such as multicriteria decision analysis appear as a way to facilitate the decision-makers' solution and ensure that the decision is made cohesively and efficiently. In the public health sector, decisions are even more delicate because they work not only with the direct influence of human needs, but also with limited financial resources. An important point for the emergency care units is the triage system, which consists of a pre-evaluation of the patients, classifying them according to the degree of life risk. Through triage, the patient can be attended more quickly and efficiently, streamlining the whole process. Thus, the present research endeavored to determine the most appropriate triage protocol for emergency healthcare units in Natal-RN city in Brazil and may help others less advanced countries to determine the most appropriate triage protocol for emergency healthcare. Methods: In this study, we used the multicriteria analysis method known as FITradeoff. In addition, interviews and structured questionnaires applied with nurses, specialists and directors. Results: Based on the questionnaires and preferences presented by the decision-makers, the Spanish Triage System was the most suitable protocol for the emergency care units, which presented with high ease of use and implementation. Conclusions: This study reached its main objective, which was to determine the most appropriate triage protocol. In addition, it was observed the possibility of new research, such as the development of a specific protocol for this emergency care units and the creation of an application software for this new protocol.

BACKGROUND AND OBJECTIVE: The growth of the urban population exerts considerable pressure on municipalities’ public managers to focus their attention on providing emergency medical care that meets the growing demand for emergency pre-hospital medical care. Currently, there are a significant number of traffic accidents and other serious occurrences, such as heart attacks, drownings, epidemics, fires and disasters (floods, landslides, earthquakes) that demand a prompt and seamless response from pre-hospital medical care. As a result of such scenario, the present article endeavours to apply a dual-coverage mathematical model (DSM-Double Standard Model) to define the optimal location of the Emergency Medical Service (SAMU) decentralized dispatch bases in Natal/RN and conduct a simulation study to evaluate the displacement of ambulances between such bases. METHODS: The methodological course that was followed by this research constitutes of 12 steps. The location of decentralized bases for sending emergency ambulances was established using the DSM model and the simulation model was performed using the FlexSim© software version 2018 evaluating base coverage in relation to the total number of calls by demand points for different scenarios. RESULTS: The results obtained throughout the research demonstrated the feasibility of redefining the decentralized bases of SAMU/Natal ambulances as a strategy to reduce response time and guarantee compliance with performance parameters established by international organizations (the World Health Organization, for instance, establishes the time of 8 minutes for emergency medical service calls response). The simulation study showed a significant reduction in response time, by up to 60% in some cases. CONCLUSION: The proposition of new locations for the decentralized dispatch bases of the SAMU/Natal can provide an overall significant reduction on the ambulance response time, so as to contribute to expedite the initiation of treatment of patients, if necessary, sent to hospitals.

Background Despite the proven value of multicriteria decision analysis in the health field, there is a lack of studies focused on prioritising victims in the Emergency Medical Service, EMS. With this, and knowing that the decision maker needs a direction on which choice may be the most appropriate, based on different and often conflicting criteria. The current work developed a new model for prioritizing victims of SAMU/192, based on the multicriteria decision methodology, taking into account the scarcity of resources. Methods An expert panel and a discussion group were formed, which defined the limits of the problem, and identified the evaluation criteria for choosing a victim, amongst four alternatives illustrated from hypothetical scenarios of emergency situations—clinical and traumatic diseases of absolute priority. For prioritization, an additive mathematical method was used that aggregates criteria in a flexible and interactive version, FITradeoff. Results The structuring of the problem led the researchers to identify twenty-five evaluation criteria, amongst which ten were essential to guide decisions. As a result, in the simulation of prioritization of four requesting victims in view of the availability of only one ambulance, the proposed model supported the decision by suggesting the prioritization of one of the victims. Conclusions This work contributed to the prioritization of victims using multicriteria decision support methodology. Selecting and weighing the criteria in this study indicated that the protocols that guide regulatory physicians do not consider all the criteria for prioritizing victims in an environment of scarcity of resources. Finally, the proposed model can support crucial decision based on a rational and transparent decision-making process that can be applied in other EMS.

BackgroundThe growth of the urban population exerts considerable pressure on municipalities’ public managers to focus their attention on providing emergency medical care that meets the growing demand for emergency pre-hospital medical care. Currently, there are a significant number of traffic accidents and other serious occurrences, such as heart attacks, drownings, epidemics, fires and disasters (floods, landslides, earthquakes) that demand a prompt and seamless response from pre-hospital medical care. As a result of such scenario, the present article endeavours to apply a dual-coverage mathematical model (DSM-Double Standard Model) to define the optimal location of the Emergency Medical Service (SAMU) decentralized dispatch bases in Natal / RN and conduct a simulation study to evaluate the displacement of ambulances between such bases. Patients and methodsThe methodological course that was followed by this research constitute for 12 steps, so as to the location of decentralized bases for sending emergency ambulances was established using the DSM model and the simulation model was performed using the FlexSim software© version 2018 evaluating base coverage in relation to the total number of calls by demand points for different scenarios.ResultsThe results obtained throughout the research demonstrated the feasibility of redefining the decentralized bases of SAMU / Natal ambulances as a strategy to reduce response time and guarantee compliance with performance parameters established by international organizations (the World Health Organization, for instance, establishes the time of 8 minutes for emergency medical service calls response). The simulation study showed a significant reduction in response time, by up to 60% in some cases.ConclusionThe proposition of new locations for the decentralized dispatch bases of the SAMU/Natal can provide an overall significant reduction on the ambulance response time, so as to contributes to expedite the initiation of treatment of patients, if necessary, sent to hospitals.