Impact of the funding reform of teaching hospitals in Brazil
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Data de Publicação: | 2009 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/32619 |
Resumo: | OBJECTIVE: To assess the impact of funding reform on the productivity of teaching hospitals. METHODS: Based on the Information System of Federal University Hospitals of Brazil, 2003 and 2006 efficiency and productivity were measured using frontier methods with a linear programming technique, data envelopment analysis, and input-oriented variable returns to scale model. The Malmquist index was calculated to detect changes during the study period: "technical efficiency change," or the relative variation of the efficiency of each unit; and "technological change" after frontier shift. RESULTS: There was 51% mean budget increase and improvement of technical efficiency of teaching hospitals (previously 11, 17 hospitals reached the empirical efficiency frontier) but the same was not seen for the technology frontier. Data envelopment analysis set benchmark scores for each inefficient unit (before and after reform) and there was a positive correlation between technical efficiency and teaching intensity and dedication. CONCLUSIONS: The reform promoted management improvements but there is a need of further follow-up to assess the effectiveness of funding changes. |
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Impact of the funding reform of teaching hospitals in Brazil Impacto de la reforma del financiamiento de hospitales de enseñanza en Brasil Impacto da reforma de financiamento de hospitais de ensino no Brasil HospitalsTeaching^i2^sorganization & administratCosts and Cost AnalysisRates^i2^sRatios and ProportiRates^i2^smethFinancial ManagementHospitalEconomicsEfficiencyOrganizationalHospitais de Ensino^i1^sorganização & administraCustos e Análise de CustoTaxas^i1^sRazões e ProporçTaxas^i1^smétoAdministração Financeira de HospitaisEconomia HospitalarEficiência OrganizacionalHospitales Escuela^i3^sorganización & administracCostos y Análisis de CostoTasas^i3^sRazones y ProporcioTasas^i3^smétoAdministración Financiera de HospitalesEconomía HospitalariaEficiencia Organizacional OBJECTIVE: To assess the impact of funding reform on the productivity of teaching hospitals. METHODS: Based on the Information System of Federal University Hospitals of Brazil, 2003 and 2006 efficiency and productivity were measured using frontier methods with a linear programming technique, data envelopment analysis, and input-oriented variable returns to scale model. The Malmquist index was calculated to detect changes during the study period: "technical efficiency change," or the relative variation of the efficiency of each unit; and "technological change" after frontier shift. RESULTS: There was 51% mean budget increase and improvement of technical efficiency of teaching hospitals (previously 11, 17 hospitals reached the empirical efficiency frontier) but the same was not seen for the technology frontier. Data envelopment analysis set benchmark scores for each inefficient unit (before and after reform) and there was a positive correlation between technical efficiency and teaching intensity and dedication. CONCLUSIONS: The reform promoted management improvements but there is a need of further follow-up to assess the effectiveness of funding changes. OBJETIVO: Evaluar el impacto de la reforma de financiamiento en la productividad de hospitales de enseñanza. MÉTODOS: A partir del Sistema de Informaciones de los Hospitales Universitarios Federales de Brasil, se construyeron fronteras de eficiencia y productividad en 2003 y 2006 con técnicas de programación linear, por medio de análisis envoltorio de datos, considerando retornos variables de escala y orientación a input. Se calculó el Índice de Malmquist para identificar cambios de desempeño a lo largo de los años con relación a la eficiencia técnica (cociente entre los puntajes de eficiencia en tiempos distintos) y eficiencia tecnológica (desplazamiento de la frontera en el período considerado). RESULTADOS: Hubo aumento del aporte financiero en 51% y de la eficiencia técnica de los hospitales de enseñanza (de 11, pasaron a ser 17 en la frontera empírica de eficiencia), no ocurriendo el mismo con la frontera tecnológica. El uso del análisis envoltorio de datos estableció los benchmarks para las unidades ineficientes (antes y después de la reforma) y los puntajes de eficiencia mostraron una posible correlación entre la eficiencia técnica encontrada y la intensidad y dedicación de enseñanza. CONCLUSIONES: La reforma permitió el desarrollo de mejoras gerenciales, pero es necesario mayor tiempo de acompañamiento para observar cambios más efectivos del modelo de financiamiento. OBJETIVO: Avaliar o impacto da reforma de financiamento na produtividade de hospitais de ensino. MÉTODOS: A partir do Sistema de Informações dos Hospitais Universitários Federais, foram construídas fronteiras de eficiência e produtividade em 2003 e 2006 com técnicas de programação linear, por meio de análise envoltória de dados, considerando retornos variáveis de escala e orientação a input. Calculou-se o Índice de Malmquist para identificar mudanças de desempenho ao longo dos anos quanto à eficiência técnica (razão entre os escores de eficiência em tempos distintos) e eficiência tecnológica (deslocamento da fronteira no período considerado). RESULTADOS: Houve aumento do aporte financeiro em 51% e da eficiência técnica dos hospitais de ensino (de 11, passaram a ser 17 na fronteira empírica de eficiência), o mesmo não ocorrendo com a fronteira tecnológica. O uso de análise envoltória de dados estabeleceu os benchmarks para as unidades ineficientes (antes e depois da reforma) e os escores de eficiência mostraram uma possível correlação entre a eficiência técnica encontrada e a intensidade e dedicação de ensino. CONCLUSÕES: A reforma permitiu o desenvolvimento de melhorias gerenciais, mas é necessário maior tempo de acompanhamento para observar mudanças mais efetivas do modelo de financiamento. Universidade de São Paulo. Faculdade de Saúde Pública2009-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/3261910.1590/S0034-89102009005000023Revista de Saúde Pública; Vol. 43 No. 3 (2009); 437-445 Revista de Saúde Pública; Vol. 43 Núm. 3 (2009); 437-445 Revista de Saúde Pública; v. 43 n. 3 (2009); 437-445 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/rsp/article/view/32619/34988Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessLobo, MSC Silva, ACM Lins, MPE Fiszman, R 2012-07-09T02:00:26Zoai:revistas.usp.br:article/32619Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-07-09T02:00:26Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Impact of the funding reform of teaching hospitals in Brazil Impacto de la reforma del financiamiento de hospitales de enseñanza en Brasil Impacto da reforma de financiamento de hospitais de ensino no Brasil |
title |
Impact of the funding reform of teaching hospitals in Brazil |
spellingShingle |
Impact of the funding reform of teaching hospitals in Brazil Lobo, MSC Hospitals Teaching^i2^sorganization & administrat Costs and Cost Analysis Rates^i2^sRatios and Proporti Rates^i2^smeth Financial Management Hospital Economics Efficiency Organizational Hospitais de Ensino^i1^sorganização & administra Custos e Análise de Custo Taxas^i1^sRazões e Proporç Taxas^i1^sméto Administração Financeira de Hospitais Economia Hospitalar Eficiência Organizacional Hospitales Escuela^i3^sorganización & administrac Costos y Análisis de Costo Tasas^i3^sRazones y Proporcio Tasas^i3^sméto Administración Financiera de Hospitales Economía Hospitalaria Eficiencia Organizacional |
title_short |
Impact of the funding reform of teaching hospitals in Brazil |
title_full |
Impact of the funding reform of teaching hospitals in Brazil |
title_fullStr |
Impact of the funding reform of teaching hospitals in Brazil |
title_full_unstemmed |
Impact of the funding reform of teaching hospitals in Brazil |
title_sort |
Impact of the funding reform of teaching hospitals in Brazil |
author |
Lobo, MSC |
author_facet |
Lobo, MSC Silva, ACM Lins, MPE Fiszman, R |
author_role |
author |
author2 |
Silva, ACM Lins, MPE Fiszman, R |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Lobo, MSC Silva, ACM Lins, MPE Fiszman, R |
dc.subject.por.fl_str_mv |
Hospitals Teaching^i2^sorganization & administrat Costs and Cost Analysis Rates^i2^sRatios and Proporti Rates^i2^smeth Financial Management Hospital Economics Efficiency Organizational Hospitais de Ensino^i1^sorganização & administra Custos e Análise de Custo Taxas^i1^sRazões e Proporç Taxas^i1^sméto Administração Financeira de Hospitais Economia Hospitalar Eficiência Organizacional Hospitales Escuela^i3^sorganización & administrac Costos y Análisis de Costo Tasas^i3^sRazones y Proporcio Tasas^i3^sméto Administración Financiera de Hospitales Economía Hospitalaria Eficiencia Organizacional |
topic |
Hospitals Teaching^i2^sorganization & administrat Costs and Cost Analysis Rates^i2^sRatios and Proporti Rates^i2^smeth Financial Management Hospital Economics Efficiency Organizational Hospitais de Ensino^i1^sorganização & administra Custos e Análise de Custo Taxas^i1^sRazões e Proporç Taxas^i1^sméto Administração Financeira de Hospitais Economia Hospitalar Eficiência Organizacional Hospitales Escuela^i3^sorganización & administrac Costos y Análisis de Costo Tasas^i3^sRazones y Proporcio Tasas^i3^sméto Administración Financiera de Hospitales Economía Hospitalaria Eficiencia Organizacional |
description |
OBJECTIVE: To assess the impact of funding reform on the productivity of teaching hospitals. METHODS: Based on the Information System of Federal University Hospitals of Brazil, 2003 and 2006 efficiency and productivity were measured using frontier methods with a linear programming technique, data envelopment analysis, and input-oriented variable returns to scale model. The Malmquist index was calculated to detect changes during the study period: "technical efficiency change," or the relative variation of the efficiency of each unit; and "technological change" after frontier shift. RESULTS: There was 51% mean budget increase and improvement of technical efficiency of teaching hospitals (previously 11, 17 hospitals reached the empirical efficiency frontier) but the same was not seen for the technology frontier. Data envelopment analysis set benchmark scores for each inefficient unit (before and after reform) and there was a positive correlation between technical efficiency and teaching intensity and dedication. CONCLUSIONS: The reform promoted management improvements but there is a need of further follow-up to assess the effectiveness of funding changes. |
publishDate |
2009 |
dc.date.none.fl_str_mv |
2009-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/32619 10.1590/S0034-89102009005000023 |
url |
https://www.revistas.usp.br/rsp/article/view/32619 |
identifier_str_mv |
10.1590/S0034-89102009005000023 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/32619/34988 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 43 No. 3 (2009); 437-445 Revista de Saúde Pública; Vol. 43 Núm. 3 (2009); 437-445 Revista de Saúde Pública; v. 43 n. 3 (2009); 437-445 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221789424451584 |