Revista de Saúde Pública
On-line version ISSN 1518-8787
LOBO, MSC; SILVA, ACM; LINS, MPE and FISZMAN, R. Impact of the funding reform of teaching hospitals in Brazil. Rev. Saúde Pública [online]. 2009, vol.43, n.3, pp. 437-445. Epub Apr 10, 2009. ISSN 1518-8787. http://dx.doi.org/10.1590/S0034-89102009005000023.
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.
Keywords : Hospitals, Teaching [organization & administration]; Costs and Cost Analysis; Rates [Ratios and Proportions]; Rates [methods]; Financial Management, Hospital; Economics, Hospital; Efficiency, Organizational.