Efficency and Productivity of Health Care Spending, Actions and Services in Major Municipalities in Ceará under Constitutional Amendment 95/2016
DOI:
https://doi.org/10.21118/apgs.v14i1.12697Abstract
Research objective: To evaluate the efficiency and productivity of health care spending, actions and services in the most populous municipalities of the State of Ceará (Brazil), under constitutional amendment 95/2016 (EC95).
Teoretical framework: The study addresses the allocation of health care resources, a challenge for municipal managers concerned with the universality of public health care during times of economic downturn and fiscal austerity imposed by EC95.
Methodology: Output-oriented data envelopment analysis, the Malmquist Index, and BCC models were used to measure the efficiency and productivity of health care spending, actions and services in the 36 most populous municipalities of Ceará, covering the period 2015-2018.
Results: After the passage of EC95, more municipalities were classified as efficient, and the overall efficiency score was higher, but no correlation was found between efficiency and per capita GDP or ‘IEGM_Saúde’ (a municipal management index). Total productivity also increased in the years after EC95.
Originality: Earlier studies have analyzed the association between per capita GDP and the efficiency of health care spending in Ceará, but this is the first study to evaluate ‘IEGM_Saúde’ in this context. Moreover, our analysis of the influence of EC95 on efficiency and productivity offers novel subsidies for public health policy making in Ceará.
Teoretical and practical contributions: In theory, EC95 favors the efficiency and productivity of health care spending, although some negative impacts have been reported. Municipalities with higher per capita GDP and ‘IEGM_Saúde’ are not necessarily more efficient at allocating health care resources.
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