巴西首都的初级保健效率和管理模式:2008-2019年
André Luis Paes Ramos1, Marismary Horsth De Seta1, Marcelo Battesini2
1Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Programa de Pós-graduação em Saúde Pública. Rio de Janeiro, RJ, Brasil.
Revista de saude publica
|May 7, 2025
概括
第三方管理没有提高巴西州首都的初级医疗保健效率. 与第三方管理服务相比,直接公共管理系统始终表现出更高的效率和结果.
科学领域:
- 公共卫生 公共卫生
- 医疗服务管理 医疗服务管理
- 卫生经济学 卫生经济学
背景情况:
- 初级卫生保健 (PHC) 对人口健康结果至关重要.
- 管理模式,包括直接公共管理和第三方合同,其对医疗保健效率的影响各不相同.
- 分析巴西各州首都的公共卫生控制效率对于了解资源配置和服务提供至关重要.
研究的目的:
- 评估2008年至2019年间巴西各州首都的初级医疗保健效率.
- 为了比较直接公共管理的效率与第三方管理模式在PHC.
- 根据管理结构,根据时间来确定PHC效率的趋势.
主要方法:
- 一项分析性,评估性研究,使用了2008年,2012年,2016年和2019年的二次,公开可用的数据.
- 利用了人口,社会经济和七个关键的PHC指标 (例如,覆盖范围,敏感条件住院,死亡率,梅毒发病率).
- 雇员数据包围分析 (DEA) 用于计算效率和马尔姆奎斯特指数来计算生产力增长.
主要成果:
- 由第三方管理的资本 (例如,圣保罗,里约热内卢) 没有显示出比直接公共管理下的资本更高的效率.
- 直接公共行政模式在2019年和纵向上始终实现了最大的相对效率.
- 第三方管理的资本表现出持续的低效率,表明与高效资本相比,投资与结果之间的关系较弱.
结论:
- 没有证据支持在巴西初级医疗保健中采用第三方管理来提高效率.
- 在研究期间,直接公共管理显示出更高的效率.
- 生产效率并不能自动等同于满足人口的健康需求.
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