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Economias de escala na oferta de serviços públicos de saúde: um estudo para os municípios paulistas

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  • Lucas Novaes

    (FGV-SP e CEPESP)

  • Enlinson Mattos

    (FEA-USP e CEPESP)

  • Fabiana Rocha

    (FGV-SP e CEPESP)

  • Paulo Arvate

    (FGV-SP e CEPESP)

  • Veronica Orellano

    (FGV-SP e CEPESP)

Abstract

Este artigo avalia os efeitos das variáveis de escala na oferta de serviços públicos de saúde dos municípios paulistas, com o objetivo de investigar os possíveis efeitos do processo de descentralização dos serviços de saúde a partir da consolidação do Sistema Único de Saúde (SUS). Foram construídos indicadores de eficiência dos gastos municipais em saúde pela técnica de Free Disposable Hull, tendo sido estimados os efeitos das variáveis de escala não só sobre a eficiência, mas também diretamente sobre os indicadores de desempenho e sobre os gastos per capita. Conclui-se que os municípios menores, além de terem maior gasto per capita em saúde, oferecem piores condições de acesso ao sistema. Além disso, pequenos municípios não oferecem melhores serviços de prevenção de doenças infecciosas, apesar de terem, a princípio, melhores condições de conhecer as necessidades dos cidadãos. Em consonância com o trabalho de Sampaio de Souza et alii (2005), conclui-se que a excessiva descentralização na gestão pode levar à perda de eficiência, aumentando gastos sem necessariamente melhorar a qualidade.

(This abstract was borrowed from another version of this item.)

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Bibliographic Info

Paper provided by ANPEC - Associação Nacional dos Centros de Pósgraduação em Economia [Brazilian Association of Graduate Programs in Economics] in its series Anais do XXXVI Encontro Nacional de Economia [Proceedings of the 36th Brazilian Economics Meeting] with number 200807181429220.

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Date of creation: 2008
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Handle: RePEc:anp:en2008:200807181429220

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  1. Ravallion, Martin, 2003. "In measuring aggregate"social efficiency"," Policy Research Working Paper Series 3166, The World Bank.
  2. Jayasuriya, Ruwan & Wodon, Quentin, 2003. "Measuring and Explaining Country Efficiency in Improving Health and Education Indicators," MPRA Paper 11183, University Library of Munich, Germany.
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  6. Pitt, Mark M. & Lee, Lung-Fei, 1981. "The measurement and sources of technical inefficiency in the Indonesian weaving industry," Journal of Development Economics, Elsevier, vol. 9(1), pages 43-64, August.
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