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Production efficiency and financing of public health: an analysis of small municipalities in the state of São Paulo — Brazil

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Abstract

This paper measured the variations in performance of small municipalities in the State of São Paulo, Brazil, regarding the technical efficiency in the use of public funds in public primary health care actions concerning the funding profile, in a scenario of fiscal federalism. Technical efficiency is one of the parameters of evaluation of public sector performance and was measured by means of Data Envelopment Analysis (DEA). The correlation analysis of DEA score was used to verify possible associations between technical efficiency and the funding profile of expenses with health care. The results showed that 6.41% of the municipalities were considered efficient. They also showed that the level of municipality dependence to inter-governmental general purpose grants and the national health funding specific purpose grants have negative correlation with efficiency scores.

Resumo

Este artigo mediu as variações de desempenho de pequenos municípios do Estado de São Paulo, Brasil, em relação à eficiência técnica no uso dos recursos públicos em ações de atenção básica à saúde em função do perfil de financiamento, em um cenário de federalismo fiscal. Eficiência técnica é um dos parâmetros de avaliação do desempenho no setor público e foi mensurada por meio da Data Envelopment Analysis (DEA). A Análise de Correlação do escore DEA foi usada para verificar possíveis associações entre eficiência e perfil de financiamento de despesas com saúde. Os resultados mostraram que 6,41% dos municípios foram considerados eficientes. Também indicaram que o grau de dependência dos municípios por transferências intergovernamentais de propósito geral e as transferências de propósito específico do fundo nacional de saúde têm correlação negativa com os escores de eficiência.

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Acknowledgements

The authors wish to thank FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo) for the support given to this project and CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) for the grant during doctoral studies.

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Authors and Affiliations

  1. Observatório de Gestão Pública, School of Economics, Business Administration and Accountancy, University of São Paulo, São Paulo, Brazil

    Patrícia Siqueira Varela, Gilberto de Andrade Martins & Luiz Paulo Lopes Fávero

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  1. Patrícia Siqueira Varela
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  2. Gilberto de Andrade Martins
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  3. Luiz Paulo Lopes Fávero
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Correspondence to Patrícia Siqueira Varela.

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Varela, P.S., Martins, G.A. & Fávero, L.P.L. Production efficiency and financing of public health: an analysis of small municipalities in the state of São Paulo — Brazil. Health Care Manag Sci 13, 112–123 (2010). https://doi.org/10.1007/s10729-009-9114-y

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