Organization and performance: assessing centralization of pathology at INCA-Brazil

Abstract

Literature widely assigns positive effects on entrepreneurial orientation and firm performance to decentralization of organizational structure; at the same time, there is evidence of positive effects of centralization of complex procedures in large hospitals on the results of cancer treatment. This study intends to evaluate the effects of centralization of pathology laboratories at the National Cancer Institute (INCA) of Brazil in 2002 on the performance of diagnostic activity and cancer control. A non-parametric efficiency frontier for the pathology labs is calculated for the period 1997-2007 by means of Data Envelopment Analysis (DEA). Findings show that centralization reversed the decline of technical efficiency in the laboratories along the period 1997-2001. The main conclusion is that the DEA model brings a contribution to knowledge about change in organizational structure in public health organizations, as well as a managerial contribution on the effectiveness of centralization to improve the support of pathology labs to INCA hospitals.