Multi-directional Robust Benefit of the Doubt model: An application to the measurement of the quality of acute care services in OECD countries

While individual metrics in evaluating healthcare quality offer in-depth insights into particular areas, they frequently fail to encompass all pertinent information. Consequently, there is a growing need to develop composite measures that comprehensively assess the overall quality or performance of specific care services, especially those not covered by official OECD measures. A novel multi-directional robust Benefit-of-the-doubt approach is proposed to measure overall acute care services quality through a composite indicator while, at the same time, highlighting the potential improvement directions for each single component indicator. First, an approach based on simulated data has been carried out to better describe the advantages of the proposed approach, and then the methodology has been applied to country-level OECD data drawn from the Healthcare Quality and Outcomes programme.