Nowadays, outsourcing is considered one of the most critical strategies across various industries and sectors. A proper selection of activities for outsourcing results in organizational efficiency and enhances the ability to focus on competitive advantages, while an improper choice can lead to significant challenges. In this research, a comprehensive model is proposed for ranking outsourcing options in the service sector. The model calculates the weights of evaluation criteria based on different domains and can be applied across various job sectors. Initially, 285 outsourcing decision-making criteria were identified. Using a structured questionnaire and the Lawshe method, these criteria were reduced to 25 key indicators, and their content validity was confirmed. Subsequently, the finalized criteria were categorized into the four perspectives of the Balanced Scorecard (BSC) using a fuzzy questionnaire. The criteria were then weighted using the Fuzzy SWARA method, and finally, the outsourcing alternatives in the case study, Amir al-Momenin Hospital, were ranked using the fuzzy ARAS method. The results showed that restaurant, pharmacy, IT and technical support, and finance and accounting activities are prioritized for outsourcing with a desirability of 96%, 82%, 63%, and 36%, respectively. By providing a scientific and flexible approach, this model helps decision-makers in the service sector to make effective decisions for outsourcing by considering comprehensive indicators and appropriate weighting, thereby improving organizational productivity.
Introduction
Outsourcing has become one of the most effective strategic tools for improving organizational efficiency and focusing on core competencies. In service-based organizations—particularly in healthcare—determining which activities to outsource is a critical decision that directly affects cost, performance, and service quality. Incorrect outsourcing decisions may lead to inefficiency, increased expenses, and service deterioration. Despite its importance, many organizations lack a comprehensive and integrated framework that considers both financial and non-financial dimensions for evaluating outsourcing alternatives.
This study aims to develop a comprehensive and systematic model for ranking outsourcing options in the service sector. The model integrates the Balanced Scorecard (BSC) framework with fuzzy multi-criteria decision-making (MCDM) methods to provide a structured, data-driven basis for managerial decisions. The research applies this integrated model to a real case study in the Amir al-Momenin Hospital in Isfahan, Iran, where several service areas were evaluated for potential outsourcing.
Methodology
The research adopted a quantitative and descriptive-analytical approach. Initially, 285 decision criteria related to outsourcing were identified through literature review and expert interviews. Using the Lawshe method and content validity ratio (CVR), these criteria were reduced to 25 key indicators.
The validated indicators were classified according to the four perspectives of the Balanced Scorecard (BSC), financial, customer, internal processes, and growth and learning.
To determine the relative importance (weights) of each criterion, the Fuzzy Step-wise Weight Assessment Ratio Analysis (Fuzzy SWARA) technique was applied. This approach allows experts’ qualitative judgments to be expressed as fuzzy numbers, capturing uncertainty in human assessment.
After obtaining the weights, the Fuzzy Additive Ratio Assessment (Fuzzy ARAS) method was used to evaluate and rank the outsourcing alternatives. The model was implemented in Amir al-Momenin Hospital, where four key service areas were analyzed: 1- Catering and restaurant services, 2- Pharmacy services, 3-IT and technical support, and 4- Financial and administrative services.
Expert questionnaires and interviews were conducted among hospital managers and key staff familiar with operational performance and outsourcing processes.
Findings
The fuzzy SWARA analysis revealed that financial and process-related indicators carried the highest importance, reflecting the hospital’s priority for cost-effectiveness and efficiency improvement. The subsequent ranking through the Fuzzy ARAS method produced the following results:

Catering and Restaurant Services achieved the highest preference value (0.96),
Pharmacy Services ranked second (0.82),
Maintenance and Technical Support ranked third (0.63),
Financial and Administrative Services ranked last (0.36).
These findings indicate that outsourcing catering services would yield the most significant operational and financial benefits, while maintaining internal control over financial management is more suitable for the organization.

The results validate the proposed model’s capability to handle multiple, often conflicting criteria in a fuzzy environment, ensuring a robust and reliable decision-making process.
Discussion and Conclusion
The findings emphasize that outsourcing decisions in service fields should be made by a logical method and consider both financial and non-financial perspectives. The integration of BSC, Fuzzy SWARA, and Fuzzy ARAS provides a holistic and flexible framework that aligns strategic goals with operational realities.
This study contributes to the literature by presenting a practical decision-support model that can reduce uncertainty and subjectivity in outsourcing evaluations. In practice, hospital managers can apply this model to identify optimal outsourcing opportunities, balance efficiency and service quality, and enhance transparency in decision-making.
The proposed model can also be adapted for other service-oriented organizations. Future research may focus on extending this framework by integrating sustainability indicators, dynamic weighting mechanisms, and sensitivity analysis to strengthen the decision-making process further.