Brazilian hospitals' performance: an assessment of the unified health system (SUS)

Health Care Manag Sci. 2020 Sep;23(3):443-452. doi: 10.1007/s10729-020-09505-5. Epub 2020 May 6.

Abstract

This paper assesses the economic efficiency of Brazilian general hospitals that provide inpatient care for the Unified Health System (SUS). We combined data envelopment analysis (DEA) and spatial analysis to identify predominant clusters, measure hospital inefficiency and analyze the spatial pattern of inefficiency throughout the country. Our findings pointed to a high level of hospital inefficiency, mostly associated with small size and distributed across all Brazilian states. Many of these hospitals could increase production and reduce inputs to achieve higher efficiency standards. These findings suggest room for optimization, but inequalities in access and the matching of demand and supply must be carefully considered in any attempt to reorganize the hospital system in Brazil.

Keywords: Data envelopment analysis (DEA); Hospital services; Scale efficiency; Spatial analysis; Sustainable development goals; Technical efficiency.

MeSH terms

  • Brazil
  • Efficiency, Organizational / economics*
  • Health Care Costs / statistics & numerical data*
  • Hospital Bed Capacity / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Hospitals, General / economics*
  • Hospitals, General / organization & administration
  • Hospitals, General / standards*
  • Humans
  • Personnel, Hospital / statistics & numerical data
  • Universal Health Care*