Sustainability assessment using a fuzzy DEA aggregation approach: a healthcare application

Sustainability and performance assessment are significant aspects for organizations such as healthcare systems in order to make sustainable decisions and to improve the quality. A sustainability framework usually addresses economic, social and environmental impacts. In many real applications, uncertainty and imprecise data are also perceived. Therefore, the current study proposes a novel approach based on data envelopment analysis (DEA) to examine the sustainability performance of systems in the presence of imprecise measures. To illustrate, the performance of systems with fuzzy data from each perspective, economic, social and environmental, is evaluated while weakly disposable undesirable outputs are presented. For this purpose, the constant and variable returns to scale fuzzy non-radial approaches with undesirable outputs are introduced. Fuzzy scale efficiency scores and the returns to scale status are also appraised for each sustainability dimension. Then, the overall sustainability performance is estimated using an alternative fuzzy composite indicators aggregate approach based on DEA. Our proposed approach is applied to measure the sustainability performance of hospitals. The findings disclose informative details about overall sustainability performance in hospitals and also strengths and weaknesses in each dimension.