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

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  • Mattos, Enlinson
  • Rocha, Fabiana
  • Novaes, Lucas Martins
  • Arvate, Paulo Roberto
  • Orellano, Verônica Inês Fernandez

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.

Suggested Citation

  • Mattos, Enlinson & Rocha, Fabiana & Novaes, Lucas Martins & Arvate, Paulo Roberto & Orellano, Verônica Inês Fernandez, 2010. "Economias de escala na oferta de serviços públicos de saúde: um estudo para os municípios paulistas," Textos para discussão 269, FGV/EESP - Escola de Economia de São Paulo, Getulio Vargas Foundation (Brazil).
  • Handle: RePEc:fgv:eesptd:269
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    References listed on IDEAS

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    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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