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Efficiency of Brazilian public services of kidney transplantation: Benchmarking Brazilian states via data envelopment analysis

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  • Marina Martins Siqueira
  • Claudia Affonso Silva Araujo

Abstract

The Brazilian Public Health System, facing a national economic and political crisis, operates with tight budgets and poor physical infrastructure. Among the services it delivers, organ transplantation represents a complex process wherein inefficient resource allocation is a relevant issue. This study examines the technical and scale efficiency of the Brazilian public services in kidney transplantation, assessing the conversion of physical and labor inputs into kidney transplants using data envelopment analysis. This longitudinal analysis used a secondary database from the Brazilian Registry of Transplants having, as a unit of analysis, 23 Brazilian states that performed kidney transplants from 2013 to 2015. The Malmquist index is applied to examine productivity changes. Data were adjusted per million of population, and factors were extracted by principal component analysis. The results indicate that most states operate in a technically inefficient manner, resulting in a low mean efficiency score. Overall efficiency worsened during the analyzed period, and there was a significant disparity in performance between states, with higher scores in the South and Southeast—the most developed and wealthiest regions—than in the North and Northeast. The results provide managerial insights into the delivery of organ transplantation by the Brazilian public services on both the national and state levels, helping to identify opportunities for better resource allocation in this activity. Given the scarcity of studies that systematically assess and benchmark organ donation and transplantation, this work represents an innovative context of application and may be useful for the community of relevant policymakers, academics, and health professionals.

Suggested Citation

  • Marina Martins Siqueira & Claudia Affonso Silva Araujo, 2018. "Efficiency of Brazilian public services of kidney transplantation: Benchmarking Brazilian states via data envelopment analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(4), pages 1067-1087, October.
    • Handle: RePEc:bla:ijhplm:v:33:y:2018:i:4:p:e1067-e1087
    DOI: 10.1002/hpm.2588
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    Cited by:

    1. Francisco Javier Santos Arteaga & Debora Di Caprio & David Cucchiari & Josep M Campistol & Federico Oppenheimer & Fritz Diekmann & Ignacio Revuelta, 2021. "Modeling patients as decision making units: evaluating the efficiency of kidney transplantation through data envelopment analysis," Health Care Management Science, Springer, vol. 24(1), pages 55-71, March.
    2. Wanke, Peter & Araujo, Claudia & Tan, Yong & Antunes, Jorge & Pimenta, Roberto, 2023. "Efficiency in university hospitals: A genetic optimized semi-parametric production function," Operations Research Perspectives, Elsevier, vol. 10(C).
    3. Márcia N. F. Manoel & Sérgio P. Santos & Carla A. F. Amado, 2023. "Assessing the impact of COVID-19 on the performance of organ transplant services using data envelopment analysis," Health Care Management Science, Springer, vol. 26(2), pages 217-237, June.
    4. Alexandre Marinho & Claudia Affonso Silva Araújo, 2021. "Using data envelopment analysis and the bootstrap method to evaluate organ transplantation efficiency in Brazil," Health Care Management Science, Springer, vol. 24(3), pages 569-581, September.

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