The Dynamic Evaluation Model of Health Sustainability under MCDM Benchmarking Health Indicator Standards.

The coronavirus pandemic causing millions of deaths around the world has raised awareness of the importance of healthcare in a city, especially its efficiency in the city's system. Although the health dimension is found to have critical effects on sustainable development in addition to the existing three dimensions, the majority of sustainability assessments that are developed based on the UN's Sustainable Development Goals (SDGs) do not define standards for each indicator. On the contrary, an effective assessment model should be dynamic and suitable to the context of each city by referring to standardized criteria, such as those in a health indicator standard (HIS), instead of comparing with other cities. Hence, this research presents a new sustainability assessment model that integrates the health dimension (HEDm) with the other three dimensions generally used in studies of sustainable development (STD) and develops an assessment method to evaluate real data with references to the HIS from reliable organizations, such as the World Health Organization (WHO) and the United Nations (UN), for the SDGs. By using the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) with the framework obtained from literature reviews, ISO Standards (ISO37120, ISO37122, ISO37123) and U4SSC, the researchers formed indicators in four dimensions with a total of 15 elements and 45 indicators. Afterwards, the weight of each indicator was determined with the Analytic Hierarchy Process (AHP) conducted in each dimension and element, resulting in a four-dimensional sustainability assessment model based on HIS value that limits the need to compare with other cities. The results from Khon Kaen province have shown the weaknesses and strengths of the target city that policymakers can reference to formulate a policy and strategy to improve HIS values in each dimension to meet standards, elevate city capacity and raise quality of life for the people living in the area.

A New Dimension of Health Sustainability Model after Pandemic Crisis Using Structural Equation Model

Since the coronavirus (COVID-19) pandemic, it has been clear that the health dimension (HEDm) has a severe impact on sustainability, which was originally considered from the pillars of society, environment and economy. Hence, the integration of the health dimension into the other three pillars is plausible to define guidelines and criteria for progress monitoring and policy assessment towards a health-sustainable city. The objective of this study aims to present The Health Sustainability Model (HSM), a four-dimensional model for health sustainability (health, economy, environment, and society), using the Del-phi method to determine potential indicators agreed by eighteen experts, including physicians who deeply understand issues on health sustainability, and assess complex dimensions of health in the context of sustainability. The researchers have found that 45 indicators, later grouped into 15 elements and 4 dimensions, have a high level of agreement with Kendall's W (KW) at 0.36. The HSM was then examined by the structural equation model (SEM) with reliability and validity shown as follows: the absolute fit with CMIN/DF = 1.44, RMSEA = 0.033, GFI = 0.96, AGFI = 0.94, RMR = 0.025, and the incremental fit with NFI = 0.94, CFI = 0.98, TLI = 0.97, and IFI = 0.98. Based on the results, the model is valid, in line with the empirical data. For further application, the HSM is expected to support city planners and decision makers by identifying room for improvement in each dimension through the indicators employed in the model. In contrast to existing studies that mainly use qualitative data, by conducting quantitative assessment, the model enables policy makers to objectively evaluate conditions and appropriately design policies to improve residents' well-being.