Hospital efficiency in the SUS: an analysis of 10 hospitals of the private-public mix in the state of Mato Grosso

Abstract

The hospital care provided by Brazil’s Unified Health System (SUS) faces a challenge: to increase efficiency. In order to examine the situation of hospitals forming SUS’ public-private mix in the Brazilian state of Mato Grosso, this article compared the efficiency of 10 hospitals, including public, private and philanthropic institutions, using Data Envelopment Analysis (DEA), a method that works with multiple inputs and outputs. In this method, the efficiency rate considers the mix of inputs and outputs, being more comprehensive and reliable than a set of operating or profitability indices, and it is applicable to various types of public and nonprofit organizations. The present work is a descriptive and exploratory multicase study with a quantitative approach. We selected 10 public, private or philanthropic hospitals in three health regions in the state of Mato Grosso. This allowed comparing the efficiency found in the three hospital categories. In 2011, the philanthropic (1) and private hospitals (0.96) presented better efficiency scores than the public ones (0.84). The same occurred in the first half of 2012, when the private (0.95) and philanthropic (0.92) hospitals swapped positions but continued to perform better than the public ones (0.81). In both periods, the public hospitals had the lowest total efficiency level. Thus, in this model of DEA analysis applied to all hospitals surveyed, the private and philanthropic hospitals had a higher efficiency level than the public hospitals, which we discuss in the article.