A Hybrid Multi-Criteria Decision-Making Framework for Selecting the Most Suitable Photovoltaic Proposal in Healthcare Institutions

Reliable electricity supply is essential for healthcare institutions, particularly where grid instability can disrupt service continuity, compromise patient safety, and affect the operation of critical medical equipment. In this context, selecting an appropriate photovoltaic (PV) proposal is a complex decision problem that requires assessing technical, economic, environmental, and regulatory factors jointly. This study develops a hybrid multi-criteria decision-making framework that integrates the Fuzzy Analytic Hierarchy Process (FAHP), the Decision-Making Trial and Evaluation Laboratory (DEMATEL), and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) to support PV proposal selection in healthcare institutions. The framework was applied to four competing proposals for a hospital case study in Barranquilla, Colombia. After integrating FAHP and DEMATEL, the economic, technical, and environmental criteria received balanced interdependence-adjusted weights of 0.324, 0.337, and 0.338, respectively. At the same time, DEMATEL identified the technical dimension as the main net influencing dimension within the expert-elicited influence network. The final ranking placed Proposal 1 first, followed by Proposal 4, Proposal 2, and Proposal 3, with closeness coefficients of 0.530, 0.518, 0.498, and 0.492, respectively. Additional comparative analysis showed that omitting DEMATEL changed the winning alternative, whereas preserving the FAHP–DEMATEL weighting structure and replacing TOPSIS with MARCOS yielded the same ranking. Robustness analyses further showed that the ranking remained stable in most supplier-exclusion and leave-one-expert-out scenarios. In contrast, bootstrap-based probabilistic sensitivity analysis showed that Proposal 1 ranked first in 96.2% of the replications. These results support the practical usefulness of the proposed framework for decision-making in healthcare energy planning.