Eficiência relativa de aplicação de recursos da gestão pública da saúde para o enfrentamento da pandemia da COVID-19

Abstract

The COVID-19 pandemic has shown that comprehensiveness and universality of assistance are not effective. Efficiency is the path to optimizing public resources. The general objective of the research is to analyze the levels of relative efficiency of application of public health management resources, as well as the dimension of spatial dependence to combat the COVID- 19 pandemic in the State of Minas Gerais. The specific objectives were: (i) to carry out a systematic literature review on the efficiency of the application of public health management resources during the COVID-19 pandemic; (ii) verify the spatial dependence of the relative efficiency of application of public health management resources to combat the COVID-19 pandemic in the municipalities of Minas Gerais. The systematic literature review showed that the main determinants of the efficiency of the application of public health management resources during the COVID-19 pandemic are the structure of health systems, factors external to public health and intergovernmental relations. The literature analyzed showed that the spatial dependence of the relative efficiency of applying public health management resources to combat the COVID-19 pandemic is a research gap. For the second article, relative efficiency was estimated using data envelopment analysis, an output-oriented variable returns to scale model. All municipalities in the State of Minas Gerais were analyzed, in the years 2020, 2021 and 2022. For the inputs, the municipality's own resources applied to health and resources transferred from the state and the Union to the municipalities in the State of Minas Gerais were used. to combat the COVID-19 pandemic. The number of cases, the standardized mortality rate and the number of people recovered from COVID-19 were used as outputs. The spatial dependence of the relative efficiency of application of public health management resources to combat the COVID-19 pandemic was verified using the Global Moran I Index and the Local Moran Index. The results obtained through data envelope analysis showed that municipalities with maximum efficiency represent a small portion of the total municipalities analyzed. A large portion of municipalities are concentrated in low efficiency scores, from 0.01 to 0.20. The Moran I Global Index showed that the relative efficiency of public health management during the COVID-19 Pandemic in a municipality is correlated with neighboring municipalities. Moran's Local Index identified the significance of municipalities that showed spatial correlation. The correlated municipalities presented above-average efficiency scores and their neighbors presented above-average efficiency scores, while another group presented low efficiency scores and their neighbors presented above-average efficiency scores. The study contributes to guiding the analysis of the efficiency of public health, to discussing the universality of care, to generating social justice, generating greater well-being for society and better health conditions.