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

Author

Listed:
  • 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.)

Suggested Citation

  • Lucas Novaes & Enlinson Mattos & Fabiana Rocha & Paulo Arvate & Veronica Orellano, 2008. "Economias de escala na oferta de serviços públicos de saúde: um estudo para os municípios paulistas," Anais do XXXVI Encontro Nacional de Economia [Proceedings of the 36th Brazilian Economics Meeting] 200807181429220, ANPEC - Associação Nacional dos Centros de Pósgraduação em Economia [Brazilian Association of Graduate Programs in Economics].
  • Handle: RePEc:anp:en2008:200807181429220
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    References listed on IDEAS

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    1. António Afonso & Miguel St. Aubyn, 2004. "Non-parametric Approaches to Education and Health Expenditure Efficiency in OECD Countries," Working Papers Department of Economics 2004/01, ISEG - Lisbon School of Economics and Management, Department of Economics, Universidade de Lisboa.
    2. Fare,Rolf & Grosskopf,Shawna & Lovell,C. A. Knox, 2008. "Production Frontiers," Cambridge Books, Cambridge University Press, number 9780521072069, December.
    3. António Afonso & Ludger Schuknecht & Vito Tanzi, 2005. "Public sector efficiency: An international comparison," Public Choice, Springer, vol. 123(3), pages 321-347, June.
    4. William Greene, 2004. "Distinguishing between heterogeneity and inefficiency: stochastic frontier analysis of the World Health Organization's panel data on national health care systems," Health Economics, John Wiley & Sons, Ltd., vol. 13(10), pages 959-980.
    5. Herrera, Santiago & Pang, Gaobo, 2005. "Efficiency of public spending in developing countries : an efficiency frontier approach," Policy Research Working Paper Series 3645, The World Bank.
    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.
    7. Jayasuriya, Ruwan & Wodon, Quentin, 2003. "Measuring and Explaining Country Efficiency in Improving Health and Education Indicators," MPRA Paper 11183, University Library of Munich, Germany.
    8. Ravallion, Martin, 2005. "On Measuring Aggregate "Social Efficiency."," Economic Development and Cultural Change, University of Chicago Press, vol. 53(2), pages 273-292, January.
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    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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