Abstract
The global healthcare systems have encountered unparalleled difficulties due to the COVID-19 pandemic, underscoring the crucial significance of effective management within healthcare supply chains. This research contributes to the field of healthcare supply chain management by presenting a robust MADM methodology called lattice ordered(L q * ) q-rung orthopair multi-fuzzy soft set(L q * q-RO MFS -MADM) for supplier evaluation and ranking amidst the challenges posed by the COVID-19 pandemic. Taking inspiration from multi-fuzzy soft set and q-rung orthopair fuzzy set, the present research article proposes a novel framework known as L q * q-rung orthopair multi-fuzzy soft set (L q * qRO MFSS ), which incorporates lattice ordering in q-rung orthopair multi-fuzzy soft set. The effectiveness of the proposed model is confirmed through successful experimentation on various important operations, including union, intersection, complement, restricted union and intersection. Moreover, the verification of De Morgan’s laws for L q * qRO MFSS is carried out specifically for these operations mentioned above. To highlight the significance of the proposed L q * qRO MFSS , a multi-attribute decision-making (MADM) problem is presented, showcasing its application in the domain of healthcare supply chain management. Furthermore, a comparative analysis is conducted to elucidate the advantages of this model in comparison to existing models.
Keywords
Introduction
In recent years, healthcare suppliers played a pivotal role in maintaining healthcare services and responding to the challenges posed by the COVID-19 pandemic. Their timely and efficient provision of essential medical supplies was crucial for patient care, testing, research, and overall healthcare system functionality. The pandemic highlighted the need for robust and adaptable supply chains to ensure that healthcare systems can effectively respond to crises. Managing healthcare supply chains effectively has become crucial to ensure the smooth availability of medical items, services, and equipment, especially during difficult times. As healthcare systems grapple with increasing complexities, evolving patient needs, and dynamic market conditions, the role of supply chain management in guaranteeing patient care and operational efficiency has grown. Recent scholarly inquiries [15, 34, 35] into healthcare supply chain management have been directed towards unraveling the intricate interplay among diverse variables, encompassing elements like demand projection, supplier affiliations, inventory fine-tuning, and the incorporation of technology.
Multi-Attribute Decision Making (MADM) approaches have evolved as critical tools for assessing and selecting suppliers based on a variety of criteria in response to these problems. By carefully studying various factors such as supplier reliability, cost-effectiveness, and quality, these approaches help decision-makers to make educated decisions. The need for
Advantages and Limitations of the Proposed L
q* q - RO
MFSS
-MADM with Existing MADM Approaches
Advantages and Limitations of the Proposed L q* q - RO MFSS -MADM with Existing MADM Approaches
Multi-fuzzy sets [22, 23, 28] are a fresh application of fuzzy set theory that tackles some issues that are challenging to explain in other extensions, like pixel color, image recognition, etc. Additionally, yager introduced the term q-rung orthopair FS (
Molodtsov [13] introduced the idea of a soft set (SS), which involves using different values for choices. In a similar vein, Maji et al. [12] explored how soft sets can be applied to decision-making, defining key concepts and their characteristics. The notions of fuzzy soft sets (FSS) and intuitionistic fuzzy soft sets (IFSS) were initially introduced by Maji et al. [11]. Building upon this, Peng et al. extended IFSS to Pythagorean fuzzy soft sets (PFSS) in 2015 [16]. By hybridizing the MFS and SS models, Yang et al. [31] introduced the idea of multi-fuzzy soft sets and applied them to decision-making. The idea of an intuitionistic multi-fuzzy soft set (IMFSS) was formulated by Das and Kar [7] as a way to tackle decision-making problems.
Hussain et al. [8] presented the q - ROFSS using the concepts of SS and qROFS. Following that, a lot of researchers looked into SS, MFSS, IMFSS, hesitant multi-fuzzy soft set and their applications [2, 9, 17]. In a recent study, the concept of q-rung orthopair multi-fuzzy soft set (q-ROMFSS) was offered by Vimala et al. [26] as an extension of IMFSS, which serves several advantageous enhancements to the decision-making process. Ali et al. [1] is the first to discuss the idea of lattice ordered soft sets and some of their characteristics. Subsequently, the concept of Lattice Ordered Fuzzy Soft Set (LOFSS) was introduced in [3], providing a means of establishing rankings among parameters in decision-making scenarios, proving to be highly advantageous.
The concept of lattice ordered soft groups was initially proposed by Vimala et al. [24, 25]. Their work also involved enhancing the lattice ordered theory with neutrosophic soft sets [27]. Building on this foundation, Mahmood et al. [10] and Muhammad Bilal Khan et al. [14] introduced the concept of lattice ordered IFSS and lattice (anti-lattice) ordered double framed soft sets (LODFrSS). As a result, Lattice ordered MFSS was later introduced by Sabeena et al. [18-20] as a broader version of successful MFSS concepts aimed at solving
Here we plan to create a hybrid structure known as L
q* qRO
MFSS
based on combined properties of q - ROFS and MFSS and these combinations allow us to maximize the handling of uncertain data. The proposed L
q* qRO
MFSS
-MADM builds upon the foundation of the Lattice ordered MFSS, thereby extending and refining the existing framework. To assess the credibility of the presented L
q* qRO
MFSS
-MADM, a case study is presented in which the five suppliers are evaluated based on five distinct criteria. The following summary encapsulates the content of this article: The notion of lattice ordered q-rung orthopair multi-fuzzy soft sets (LOMFSS) presents a hybrid mathematical model that combines the qualities of LOMFSS and q - ROFS. This novel technique is significant because it provides an improved mathematical tool capable of addressing a greater range of uncertainty than both LOMFSS and q - ROFS. This hybrid model is useful in a variety of decision-making contexts when there is a specific ordering of factors, allowing for a more thorough depiction of uncertainty. The L
q* qRO
MFSS
-MADM methodology allows healthcare organizations to assess suppliers based on factors like reliability, lead times, pricing, quality, and flexibility, while robust L
q* q - RO
MFSS
manage uncertainty in supply chain data. An empirical application to the discipline of supply chain management validates the rationality and accountability of the proposed techniques. We compare our approach to existing L
q* qRO
MFSS
-MADM methods using models from the LOIFSS, LOMFSS, LODFSS, and LONSS.
The organization of the article is as outlined below: Section 2 presents the preliminary concepts of MFS, MFSS, IMFSS, q - ROFS, q - RO MFS and q - RO MFSS . Section 3 defines the novel concept known as L q* q - RO MFSS with its related properties and also define the generalized De Morgan’s laws for L q* q - RO MFS set. Section 4, provides an illustrative example on healthcare supply chain management. Section 5, gives comparative analyses, and a conclusion to demonstrate the applicability of the suggested methodology.
In this section, we present fundamental definitions and properties associated with L
q* q - RO
MFS
set. In the course of this manuscript, we use
For any If there exist elements 0 and 1 in
The set of all
The entries q
ij
are computed as follows: q
ij
= c - d, where “c” represents the count of how many times the MV
In this section, we introduce lattice-ordered (L q * ) q-rung orthopair multi-fuzzy soft sets, which is the extension of the LOMFSS. We also provide the basic definitions and fundamental operations such as arbitrary union and arbitrary intersection for the L q * q - RO MFSS .

Graphical representation of proposed methodology.
Consequently, the score increases as the region under evaluation expands, as more sales are expected to take place in larger regions. However, it is important to note that the committee has decided to assess the two products, baby moisturizer and baby wash, separately, despite both being produced by these companies. In this example, the results for each of the four regions are summarised in the tables below Table 2.

Order of parameters.
Tabular Representation of L
q
*
With all of these inputs:
(i) Use the non-empty set to identify the three companies
(ii)Indicate the four regions with the lattice of parameters
(iii) Use the set of indexes to denote the two assessment categories.
Subset: ( Equal: If ( Null: L
q
*
q - RO
MFSS
is said to be null L
q
*
q - RO
MFSS
set if Absolute: L
q
*
q - RO
MFSS
is said to be universal L
q
*
q - RO
MFSS
if Complement: The complement of L
q
*
Proof. Straightforward□
Union of two L
q
*
Intersection of two L
q
*
Restricted union of two L
q
*
Restricted intersection of L
q
*
Proof. (i) Suppose that
Proof. (ii). can be proved analogously.□
Proof. Suppose that
Proof. (ii) similar to (i).□
The process of decision-making using L q * q-RO MFSS -MADM necessitates the assessment of all potential decision alternatives, a common practice in most decision-making scenarios. However, the complexity arises from the fact that a solitary criterion is often inadequate for comprehensively evaluating all available options. Consequently, the efficacy of selecting the optimal alternative from the considered set is not consistently optimal.
This section introduces a pair of innovative and tailored algorithms designed to effectively apply the information from L q * q-RO MFSS in addressing decision-making problems. These algorithms build upon the frameworks established in the works of [31] and [33], incorporating modifications to enhance their performance within this context.
Algorithm 1
Case scenario
In a hypothetical scenario, a regional healthcare system was grappling with supply chain management during the COVID-19 pandemic. In such a crisis, the need for sustainable suppliers becomes even more critical as hospitals strive to maintain uninterrupted operations and provide effective patient care. The suppliers are assessed based on several important attributes: flexibility, reliability, cost, customer service, and quality. These attributes collectively contribute to the effectiveness of the healthcare supply chain, ensuring that medical resources are efficiently procured and distributed. To make this complex decision, they employ a specialized MADM technique called L q * q-RO MFS -MADM.
In this novel technique, a lattice structure is employed to visually represent the relationships and priorities among the aforementioned attributes in a three-dimensional framework (see Fig. 3). At the top of the lattice structure lies the most fundamental attribute,quality. Quality is the overarching concern, as healthcare supply chain management demands uncompromising standards to safeguard patient well-being. Directly beneath quality, we find reliability, positioned at the next level. Reliability closely follows quality due to its crucial role in ensuring a consistent flow of essential medical supplies. Flexibility, representing a supplier’s adaptability to fluctuating demands and unforeseen situations, is positioned at a lower level in the lattice. While it is valued, it holds a lesser position in comparison to quality and reliability. Interestingly, both cost and customer services appear independently in the lattice structure, linked directly to reliability. This signifies that while cost and customer services are not directly connected, they share a relationship with reliability and are positioned just below it. This positioning highlights the experts’ recognition of cost as an important consideration that needs to be balanced with reliability, along with the emphasis on maintaining satisfactory customer service levels. This lattice structure serves as a valuable tool for understanding the relative significance and interplay of attributes from the experts’ viewpoint.

Lattice of parameters.
Let
By looking at what others have written, the hospital found that there are five important things to think about when choosing suppliers. These things are: how much you can trust the supplier (
Algorithm 1: Calculation part
L
q
*
of dimension 3
L
q
*
L
q
*
Using Equation (1) L q * q-RO MFSS decision matrix in Tables 3 and 4 is converted into q-ROFSS shown in Tables 5 and 6.
Weighted aggregation of L
q
*
Weighted aggregation of L
q
*
Comaprison matrix
Tabular representation of the mid-level soft set (Λ f ; mid) with choice values
As a result,
In L
q
*
q-RO
MFSS
-MADM, one has the flexibility to employ various rules or thresholds as part of an adaptable approach. For instance, when addressing the issue using a mid-level decision rule, it becomes evident that the mid-level threshold of Δ
F
takes the form of a fuzzy set. mid Δ
F
=
Comaprison of proposed approach using Algorithm 1
Comaprison of proposed approach using Algorithm 1
The suggested L q * q-RO MFSS -MADM framework establishes a comprehensive method for decision-making, specifically within the realm of healthcare supplier selection amid the COVID-19 pandemic. It is compared with some existing techniques [10, 14, 19, 27] to demonstrate the proficiency of the proposed work. The obtained results are summarised in Tables 9 and 10. It is clear from these tables that the results obtained by LOMFSS [19] are the same as the proposed approach. Here the ranking is the same because we reduce the L q * q-RO MFSS to LOMFSS by only taking the membership values of the objects in the L q * q-RO MFSS and ignoring their non-membership values. However, our presented approach is not comparable with the existing approaches used in [10, 14, 27]. Thus this sophisticated framework is expected to incorporate a range of decision criteria (attributes) that hold relevance in healthcare supply chain management. These attributes may encompass elements like supplier dependability, cost, lead time, product quality, and the ability to navigate disruptions.
Comaprison of proposed approach using Algorithm 2
Comaprison of proposed approach using Algorithm 2
The primary benefits of this paper is to articulate multi-fuzzy information through the utilization of L q * q-rung orthopair multi-fuzzy soft information, which encompasses complex mathematical structures capable of accommodating uncertain and imprecise data within a multi-attribute decision-making framework. This concept exemplifies the endeavor to formulate an advanced framework that can offer heightened authenticity and precision in evaluations within intricate scenarios, such as the assessment of healthcare supplier rankings in times of uncertainty, such as the COVID-19 pandemic.
Conclusion
Recently,
Footnotes
Acknowledgments
The article has been written with the joint financial support of RUSA-Phase 2.0 grant sanctioned vide letter No.F24-51/2014-U, Policy (TN Multi-Gen), Dept. of Edn. Govt. of India, Dt. 09.10.2018, DST-PURSE 2nd Phase programme vide letter No. SR/PURSE Phase 2/38 (G) Dt. 21.02.2017 and DST (FIST - level I) 657876570 vide letter No.SR/FIST/MS-I/2018/17 Dt.20.12.2018.
