Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 51 2 2022 02 06 426 437 Sheida Mardani Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran Khalil Alimohammadzade 1. Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran 2. Health Economics Policy Research Center, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran Ali Maher 1. Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran 2. Department of Health Policy, School of Management and Medical Education Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Seyed Mojtaba Hosseini Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran Kamyar Yaghmaeian Department of Environmental Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. Center for Solid Waste Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran 2020 06 19 2020 10 14 Background: Assessing the performance of hospitals in waste management requires considering several criteria of different types. The multiplicity of the criteria and how they are weighed and, ultimately, the ranking of hospitals; are among the most complex challenges faced by the environmental health authorities. This research tried to assess the capability of four commonly used multi-criteria decision-making methods, as well as a hybrid technique for performance assessment of six hospitals in Tehran City, Iran, in 2018 regarding waste management. Methods: The effective criteria and sub-criteria were identified by reviewing the relevant literature. The data collection tool was a self-constructed checklist developed based upon the identified criteria and sub-criteria and analysis of the collected data was done in MATLAB software. The sample hospitals were ranked based on the scores given to the management performance of hospitals. Results: The final rankings by the different techniques did not differ significantly. According to the results of the hybrid method, among six studied hospitals, the top three hospitals were Hospital C, B, and A respectively, regarding hospital waste reduction criteria. These hospitals generally had an acceptable performance in terms of waste management, especially waste disinfection and separation at the origin. Conclusion: In assessing the performance and ranking of hospitals in terms of waste management, hybrid multi-criteria decision-making techniques can be used as a useful tool in waste management planning. By identifying the areas in need of corrective actions and choosing the appropriate strategy, they pave the way for improving the performance of hospitals in the field of waste management. https://ijph.tums.ac.ir/index.php/ijph/article/view/19750 https://ijph.tums.ac.ir/index.php/ijph/article/download/19750/7509