IDEAS home Printed from https://ideas.repec.org/p/anp/en2008/200807181429220.html
   My bibliography  Save this paper

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 Pós-Graduação em Economia [Brazilian Association of Graduate Programs in Economics].
    • Handle: RePEc:anp:en2008:200807181429220
    as

    Download full text from publisher

    File URL: http://www.anpec.org.br/encontro2008/artigos/200807181429220-.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Fare,Rolf & Grosskopf,Shawna & Lovell,C. A. Knox, 2008. "Production Frontiers," Cambridge Books, Cambridge University Press, number 9780521072069, October.
    2. 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.
    3. Fried, Harold O. & Lovell, C. A. Knox & Schmidt, Shelton S. (ed.), 1993. "The Measurement of Productive Efficiency: Techniques and Applications," OUP Catalogue, Oxford University Press, number 9780195072181.
    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, October.
    5. Jayasuriya, Ruwan & Wodon, Quentin, 2003. "Measuring and Explaining Country Efficiency in Improving Health and Education Indicators," MPRA Paper 11183, University Library of Munich, Germany.
    6. Ravallion, Martin, 2005. "On Measuring Aggregate "Social Efficiency."," Economic Development and Cultural Change, University of Chicago Press, vol. 53(2), pages 273-292, January.
    7. 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.
    8. 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.
    9. António Afonso & Ludger Schuknecht & Vito Tanzi, 2005. "Public sector efficiency: An international comparison," Public Choice, Springer, vol. 123(3), pages 321-347, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Rouselle Lavado & Emilyn Cabanda, 2009. "The efficiency of health and education expenditures in the Philippines," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 17(3), pages 275-291, September.
    2. António Afonso & Sónia Fernandes, 2003. "Efficiency of Local Government Spending: Evidence for the Lisbon Region," Working Papers Department of Economics 2003/09, ISEG - Lisbon School of Economics and Management, Department of Economics, Universidade de Lisboa.
    3. 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.
    4. Jean-François Brun & Constantin Thierry Compaore, 2021. "Public Expenditures Efficiency On Education Distribution in Developing Countries," Working Papers hal-03116615, HAL.
    5. Andrés Felipe SALAZAR CUELLAR, 2014. "The Efficiency of Education Expenditure in Latin America and Lessons for Colombia," Archivos de Economía 11209, Departamento Nacional de Planeación.
    6. Contreras, Dulce/D & Sánchez, Rosario/R & Soria, Delfina/D, 2012. "Mobility, wages and gender across Europe," MPRA Paper 42589, University Library of Munich, Germany, revised Nov 2012.
    7. Philippe K. Widmer & Peter Zweifel, 2008. "Public Good Provision in a Federalist Country: Tiebout Competition, Fiscal Equalization, and Incentives for Efficiency in Switzerland," SOI - Working Papers 0804, Socioeconomic Institute - University of Zurich, revised Dec 2010.
    8. Estache, Antonio & Gonzalez, Marianela & Trujillo,Lourdes, 2007. "Government expenditures on education, health, and infrastructure : a naive look at levels, outcomes, and efficiency," Policy Research Working Paper Series 4219, The World Bank.
    9. Ablam Estel APETI & Bao-We-Wal BAMBE & Jean Louis COMBES, 2022. "On the Macroeconomic Effects of Fiscal Reforms : Fiscal Rules and Public Expenditure Efficiency," LEO Working Papers / DR LEO 2985, Orleans Economics Laboratory / Laboratoire d'Economie d'Orleans (LEO), University of Orleans.
    10. Keller, Michael, 2020. "Wasted windfalls: Inefficiencies in health care spending in oil rich countries," Resources Policy, Elsevier, vol. 66(C).
    11. Santiago Herrera & Gaobo Pang, 2006. "How Efficient is Public Spending in Education?," Revista ESPE - Ensayos Sobre Política Económica, Banco de la República, vol. 24(51), pages 136-201, June.
    12. Antonis Adam & Manthos Delis & Pantelis Kammas, 2011. "Public sector efficiency: leveling the playing field between OECD countries," Public Choice, Springer, vol. 146(1), pages 163-183, January.
    13. Antonis Adam & Manthos Delis & Pantelis Kammas, 2014. "Fiscal decentralization and public sector efficiency: evidence from OECD countries," Economics of Governance, Springer, vol. 15(1), pages 17-49, February.
    14. Munir Ahmad & Azkar Ahmad, 1998. "An Analysis of the Sources of Wheat Output Growth in the Barani Area of the Punjab," The Pakistan Development Review, Pakistan Institute of Development Economics, vol. 37(3), pages 231-249.
    15. Rafael Sanchez & Francisca Pacheco, 2014. "A Longitudinal Parametric Approach to Estimate Local Government Efficiency," Working Papers wp_033, Adolfo Ibáñez University, School of Government.
    16. António Afonso & Sónia Fernandes, 2005. "Assessing and Explaining the Relative Efficiency of Local Government: Evidence for Portuguese Municipalities," Working Papers Department of Economics 2005/19, ISEG - Lisbon School of Economics and Management, Department of Economics, Universidade de Lisboa.
    17. Novignon, Jacob & Lawanson, Akanni, 2014. "Efficiency of health systems in sub-Sahara Africa: a comparative analysis of time varying stochastic frontier models," MPRA Paper 56897, University Library of Munich, Germany.
    18. Afonso, António & Fernandes, Sónia, 2008. "Assessing and explaining the relative efficiency of local government," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 37(5), pages 1946-1979, October.
    19. Hauner, David & Kyobe, Annette, 2010. "Determinants of Government Efficiency," World Development, Elsevier, vol. 38(11), pages 1527-1542, November.
    20. Abdul Wadud, 2013. "Impact of Microcredit on Agricultural Farm Performance and Food Security in Bangladesh," Working Papers 14, Institute of Microfinance (InM).

    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

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:anp:en2008:200807181429220. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Rodrigo Zadra Armond (email available below). General contact details of provider: https://edirc.repec.org/data/anpecea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.