Decision making

Published en El Pais, December 4th 2019.

Today, decision making has become more important. Above all, to maintain aspects of effectiveness. For the health sector, it is being seen that, although having universal access to health is a priority and commitment to the SDG2030 Objectives, it is also true that countries do not have sufficient income to cover all existing needs. Therefore, today more than ever, it is important to know how you are going to decide, define a method and a procedure that helps you make decisions. At the same time, it is important to make this process transparent so that people maintain their trust in the government.

There are three major approaches we could take to know which health program can be financed and up to what percentage. One is the qualitative approach, another is the quantitative approach, and another is a mixed approach, that is, a mixture of both. Many people will think that the best is mixed, but do we have the possibility to choose?

An important aspect to make decisions is information, with a good quality and with the least possible error (less asymmetry and uncertainty). The quantitative approach gives the best quality of information and with less error. But not all countries collect data in the desired detail, not all have it available in a database but on only paper, or due to various regulations, the data cannot be accessed. Then, we have the qualitative form. In recent years, techniques and instruments have been refined to collect qualitative information and transform it to a numerical form to give it greater added value. Despite the effort in this regard, we must not forget that qualitative information works with small samples of the population and may be biased by the size of their sample, the form of their choice and the researcher’s interaction effect. However, its value is in the deep explanation of social-economic or political aspects that numbers simply do not indicate. Therefore, both information approaches are important along with the context in which this information is collected.

In order to make decisions in the health sector and define an adequate universal coverage program, it is important to start collecting clear and transparent information and take advantage of available technologies such as the internet. Both approaches to information are necessary because the numbers may say that “few patients came” in the month, but the qualitative may explain that it is because there were blockades or because there were no medical positions or that people distrust going to a health center that is not equipped. Only in this way, better decisions can be made with a low level of error that helps to propose appropriate strategies to solve the real problem.