Analysis of the performance of public and private hospitals serving the Brazilian Unified National Health System

Detalhes bibliográficos
Autor(a) principal: Manassi Panitz, Leandro
Data de Publicação: 2024
Outros Autores: Nadler Prata, David, Rodrigues, Waldecy
Tipo de documento: Artigo
Idioma: por
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8706
Resumo: This article aims to analyze the performance of the Brazilian Unified National Health System (SUS, acronym in Portuguese) hospital network based on the national databases of the Brazilian Hospital Information System (SIH, acronym in Portuguese) and the Brazilian National Registry of Health Establishments (CNES, acronym in Portuguese). The research used a set of indicators covering the production of admissions, the profile, quality and performance of care, associated with hospital size and legal nature. For data analysis, the Analysis of Variance with Tukey-Kramer test was used to highlight the differences between public and private hospitals, the moderation analysis to verify the effect of hospital size and the Pabon Lasso model to integrate the results. The results show that the increase in the number of beds influences the performance of the indicators differently for public and private hospitals. Public hospitals showed higher gains in scale efficiency with the increase in beds, whereas private non-profit hospitals showed a higher performance in the set of indicators and a more balanced performance in the different sizes. The application of the Pabon Lasso model showed that small hospitals, both public and private, perform poorly. It also showed that from medium-sized onwards, public and private hospitals perform well. However, each category displays particularities in its performance profile, reflecting a diversity of practices and operational results. This study thus confirms previous findings that hospital performance tends to improve as the number of beds increases, but also reveals that it varies significantly depending on the legal nature of these institutions.
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spelling Analysis of the performance of public and private hospitals serving the Brazilian Unified National Health SystemAnálisis del desempeño de hospitales públicos y privados que cubren el Sistema Único de Salud brasileñoAnálise do desempenho dos hospitais públicos e privados que atendem ao Sistema Único de SaúdeSistemas de Informação Hospitalar; Assistência Hospitalar; Benchmarking; Sistema Único de SaúdeSistemas de Información Hospitalaria; Atención Hospitalaria; Benchmarking; Sistema Único de SaludHospital Information Systems; Hospital Care; Benchmarking; Unified Health SystemThis article aims to analyze the performance of the Brazilian Unified National Health System (SUS, acronym in Portuguese) hospital network based on the national databases of the Brazilian Hospital Information System (SIH, acronym in Portuguese) and the Brazilian National Registry of Health Establishments (CNES, acronym in Portuguese). The research used a set of indicators covering the production of admissions, the profile, quality and performance of care, associated with hospital size and legal nature. For data analysis, the Analysis of Variance with Tukey-Kramer test was used to highlight the differences between public and private hospitals, the moderation analysis to verify the effect of hospital size and the Pabon Lasso model to integrate the results. The results show that the increase in the number of beds influences the performance of the indicators differently for public and private hospitals. Public hospitals showed higher gains in scale efficiency with the increase in beds, whereas private non-profit hospitals showed a higher performance in the set of indicators and a more balanced performance in the different sizes. The application of the Pabon Lasso model showed that small hospitals, both public and private, perform poorly. It also showed that from medium-sized onwards, public and private hospitals perform well. However, each category displays particularities in its performance profile, reflecting a diversity of practices and operational results. This study thus confirms previous findings that hospital performance tends to improve as the number of beds increases, but also reveals that it varies significantly depending on the legal nature of these institutions.Este artículo tiene como objetivo analizar el desempeño de la red hospitalaria del Sistema Único de Salud brasileño (SUS, por sus siglas en portugués) a partir de las bases de datos nacionales del Sistema de Información Hospitalaria (SIH, por sus siglas en portugués) y del Registro Nacional de Establecimientos de Salud (CNES, por sus siglas en portugués). Para ello, se utilizó un conjunto de indicadores que cubren la producción de hospitalizaciones, el perfil de la atención, la calidad y el desempeño asociados con la capacidad de los hospitales y la naturaleza legal. El análisis de varianza con prueba de Tukey-Kramer se utilizó en el análisis de datos para identificar las diferencias entre los hospitales públicos y privados; el análisis de moderación para verificar el efecto de la capacidad del hospital; y el modelo Pabon Lasso para integrar los resultados. Los resultados mostraron que un aumento en la cantidad de camas influye en el desempeño de los indicadores de manera distinta tanto en los hospitales públicos como en los privados. Los hospitales públicos tuvieron mayor ganancia de eficiencia de escala con el aumento de camas, mientras que los hospitales privados sin fines de lucro mostraron un mejor desempeño en el conjunto de indicadores y más equilibrado en las diferentes capacidades. La aplicación del modelo Pabon Lasso demostró que los pequeños hospitales, tanto públicos como privados, tuvieron un bajo desempeño. También mostró que los hospitales públicos o privados de mediano tamaño tuvieron un buen desempeño. Sin embargo, cada categoría guarda particularidades en su perfil de desempeño, reflejando una diversidad de prácticas y resultados operativos. Por lo tanto, los resultados de este estudio confirman los hallazgos previos de que el desempeño hospitalario tiende a mejorar con el aumento del número de camas, pero también revela que hay una variación significativa dependiendo de la naturaleza legal de estas instituciones.O artigo tem como objetivo analisar o desempenho da rede hospitalar do Sistema Único de Saúde (SUS) com base nos bancos de dados nacionais do Sistema de Informações Hospitalares (SIH) e do Cadastro Nacional de Estabelecimentos de Saúde (CNES). A pesquisa utilizou um conjunto de indicadores abrangendo a produção de internações, o perfil de atendimentos, a qualidade e o desempenho, associados ao porte dos hospitais e à natureza jurídica. Para análise de dados, empregou-se: a análise da variância com teste de Tukey-Kramer para evidenciar as diferenças entre hospitais públicos e privados; a análise de moderação para verificar o efeito do porte hospitalar; e o modelo Pabon Lasso para integrar os resultados. Estes demonstram que o aumento no número de leitos influencia o desempenho dos indicadores de maneira distinta para hospitais públicos e privados. Hospitais públicos apresentaram ganhos de eficiência de escala superiores com o aumento de leitos e os privados sem fins lucrativos, um desempenho superior no conjunto de indicadores e mais equilibrado nos diferentes portes. A aplicação do modelo Pabon Lasso demonstrou que hospitais pequenos, tanto públicos quanto privados, apresentam baixo desempenho, e evidenciou também que, a partir do médio porte, os hospitais públicos e privados apresentam um bom desempenho. No entanto, cada categoria exibe particularidades em seu perfil de performance, refletindo uma diversidade de práticas e resultados operacionais. Desse modo, o estudo confirma achados anteriores de que o desempenho hospitalar tende a melhorar com o aumento do número de leitos, mas revela também que ele varia significativamente em função da natureza jurídica dessas instituições.Reports in Public HealthCadernos de Saúde Pública2024-09-20info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/xmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8706Reports in Public Health; Vol. 40 No. 9 (2024): SeptemberCadernos de Saúde Pública; v. 40 n. 9 (2024): Setembro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8706/19725https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8706/19726Copyright (c) 2024 Cadernos de Saúde Públicainfo:eu-repo/semantics/openAccessManassi Panitz, LeandroNadler Prata, DavidRodrigues, Waldecy2024-09-20T16:27:52Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8706Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/cspPUBhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-09-20T16:27:52Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.none.fl_str_mv Analysis of the performance of public and private hospitals serving the Brazilian Unified National Health System
Análisis del desempeño de hospitales públicos y privados que cubren el Sistema Único de Salud brasileño
Análise do desempenho dos hospitais públicos e privados que atendem ao Sistema Único de Saúde
title Analysis of the performance of public and private hospitals serving the Brazilian Unified National Health System
spellingShingle Analysis of the performance of public and private hospitals serving the Brazilian Unified National Health System
Manassi Panitz, Leandro
Sistemas de Informação Hospitalar; Assistência Hospitalar; Benchmarking; Sistema Único de Saúde
Sistemas de Información Hospitalaria; Atención Hospitalaria; Benchmarking; Sistema Único de Salud
Hospital Information Systems; Hospital Care; Benchmarking; Unified Health System
title_short Analysis of the performance of public and private hospitals serving the Brazilian Unified National Health System
title_full Analysis of the performance of public and private hospitals serving the Brazilian Unified National Health System
title_fullStr Analysis of the performance of public and private hospitals serving the Brazilian Unified National Health System
title_full_unstemmed Analysis of the performance of public and private hospitals serving the Brazilian Unified National Health System
title_sort Analysis of the performance of public and private hospitals serving the Brazilian Unified National Health System
author Manassi Panitz, Leandro
author_facet Manassi Panitz, Leandro
Nadler Prata, David
Rodrigues, Waldecy
author_role author
author2 Nadler Prata, David
Rodrigues, Waldecy
author2_role author
author
dc.contributor.author.fl_str_mv Manassi Panitz, Leandro
Nadler Prata, David
Rodrigues, Waldecy
dc.subject.por.fl_str_mv Sistemas de Informação Hospitalar; Assistência Hospitalar; Benchmarking; Sistema Único de Saúde
Sistemas de Información Hospitalaria; Atención Hospitalaria; Benchmarking; Sistema Único de Salud
Hospital Information Systems; Hospital Care; Benchmarking; Unified Health System
topic Sistemas de Informação Hospitalar; Assistência Hospitalar; Benchmarking; Sistema Único de Saúde
Sistemas de Información Hospitalaria; Atención Hospitalaria; Benchmarking; Sistema Único de Salud
Hospital Information Systems; Hospital Care; Benchmarking; Unified Health System
description This article aims to analyze the performance of the Brazilian Unified National Health System (SUS, acronym in Portuguese) hospital network based on the national databases of the Brazilian Hospital Information System (SIH, acronym in Portuguese) and the Brazilian National Registry of Health Establishments (CNES, acronym in Portuguese). The research used a set of indicators covering the production of admissions, the profile, quality and performance of care, associated with hospital size and legal nature. For data analysis, the Analysis of Variance with Tukey-Kramer test was used to highlight the differences between public and private hospitals, the moderation analysis to verify the effect of hospital size and the Pabon Lasso model to integrate the results. The results show that the increase in the number of beds influences the performance of the indicators differently for public and private hospitals. Public hospitals showed higher gains in scale efficiency with the increase in beds, whereas private non-profit hospitals showed a higher performance in the set of indicators and a more balanced performance in the different sizes. The application of the Pabon Lasso model showed that small hospitals, both public and private, perform poorly. It also showed that from medium-sized onwards, public and private hospitals perform well. However, each category displays particularities in its performance profile, reflecting a diversity of practices and operational results. This study thus confirms previous findings that hospital performance tends to improve as the number of beds increases, but also reveals that it varies significantly depending on the legal nature of these institutions.
publishDate 2024
dc.date.none.fl_str_mv 2024-09-20
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dc.identifier.uri.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8706
url https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8706
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8706/19725
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8706/19726
dc.rights.driver.fl_str_mv Copyright (c) 2024 Cadernos de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2024 Cadernos de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/xml
application/pdf
dc.publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 40 No. 9 (2024): September
Cadernos de Saúde Pública; v. 40 n. 9 (2024): Setembro
1678-4464
0102-311X
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
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instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
collection Cadernos de Saúde Pública
repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br
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