Decision Stability in Pre-Tender Hospital CT Procurement: A Multicriteria Proof of Concept

High-cost medical equipment procurement creates long-term clinical, technical, and service dependencies, making the pre-tender stage a critical decision point. A multicriteria decision analysis proof of concept for computed tomography procurement was developed using six macrocriteria and three hypothetical scenarios. Of 43 submissions, 42 were eligible, 40 had complete Analytic Hierarchy Process matrices, and 23 met the consistency ratio threshold of 0.10 for primary weighting. Scenario-specific weights were elicited for hypothetical hospital settings: S1, a proximity hospital; S2, a high-demand general hospital; and S3, a differentiated referral hospital. These weights were applied to five hypothetical profiles using SAW, TOPSIS, and MOORA, with agreement and sensitivity analyses. Reliability and service continuity ranked highest in S1; clinical fit and reliability were nearly tied in S2; and strategic value and interoperability led S3. The balanced profile led all methods in S1 and S2, whereas TOPSIS selected a strategic profile in S3. Under one-at-a-time ±20% weight changes, first place persisted in 36/36, 36/36, and 33/36 classifications for S1, S2, and S3. In S3, a 7.1% C6 increase triggered the nearest switch, supporting reporting stability alongside rank. Findings support methodological feasibility under controlled computed tomography scenarios; application to other equipment or clinical domains requires context-specific adaptation and prospective institutional validation with real data.