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Brazilian hospitals’ performance: an assessment of the unified health system (SUS)

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Abstract

This paper assesses the economic efficiency of Brazilian general hospitals that provide inpatient care for the Unified Health System (SUS). We combined data envelopment analysis (DEA) and spatial analysis to identify predominant clusters, measure hospital inefficiency and analyze the spatial pattern of inefficiency throughout the country. Our findings pointed to a high level of hospital inefficiency, mostly associated with small size and distributed across all Brazilian states. Many of these hospitals could increase production and reduce inputs to achieve higher efficiency standards. These findings suggest room for optimization, but inequalities in access and the matching of demand and supply must be carefully considered in any attempt to reorganize the hospital system in Brazil.

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Authors and Affiliations

  1. Centro de Desenvolvimento e Planejamento Regional (Cedeplar), Universidade Federal de Minas Gerais (UFMG), Horizonte, Brazil

    Laura de Almeida Botega, Mônica Viegas Andrade & Gilvan Ramalho Guedes

  2. Universidade Federal de Minas Gerais (UFMG), Centro de Desenvolvimento e Planejamento Regional (Cedeplar), sala 2064. Av. Pres. Antonio Carlos, 6627 – Pampulha, Belo Horizonte, MG, 31270-901, Brazil

    Laura de Almeida Botega, Mônica Viegas Andrade & Gilvan Ramalho Guedes

Authors
  1. Laura de Almeida Botega
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  2. Mônica Viegas Andrade
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  3. Gilvan Ramalho Guedes
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Correspondence to Laura de Almeida Botega.

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Highlights

• This is the first study to estimate technical and scale efficiency using Data Envelopment Analysis for all Brazilian general hospitals.

• Brazilian hospitals operate, on average, on low levels of technical and scale efficiency, but efficiency varies by hospital size and by healthcare provider.

• Most of the hospitals operate on increasing returns to scale, suggesting that there is room for resources optimization.

• Hospital inefficiency can be found in units across all Brazilian states.

• Municipalities with higher levels of human development concentrate a larger share of hospitals with higher technical efficiency.

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de Almeida Botega, L., Andrade, M.V. & Guedes, G.R. Brazilian hospitals’ performance: an assessment of the unified health system (SUS). Health Care Manag Sci 23, 443–452 (2020). https://doi.org/10.1007/s10729-020-09505-5

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  • DOI: https://doi.org/10.1007/s10729-020-09505-5

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