Efficiency analysis in public health organizations in Brazil

Abstract

PurposeThis paper aims to discuss and collect evidence about the hypothesis that, under imperfect information, the multipurpose public organization emulates its peers, arguing that this hypothesis can be fruitful to the study of this kind of organization.Design/methodology/approachAt IPEC – Instituto de Pesquisa Clínica Evandro Chagas, the clinical research institute affiliated to FIOCRUZ – Fundação Oswaldo Cruz, activities relating to infectious diseases –, e.g. diagnostic exams; outpatient care and patient admissions; teaching and research – are structured in the form of integrated action programs (briefly, PAIs). Taking into account the complexity of this organizational format, this paper applies a mathematical model allowing to define and compute managerial indicators referring to the eight main PAI programs with a view to measure their performance, to investigate whether there are any scale inefficiencies in the eight programs selected as decision‐making units (DMUs) and to assess the effectiveness of the whole organizational structure. To accomplish those objectives, the paper employs the so‐called DEA models with variable returns to scale – whereby two input and seven output variables were used to represent the eight DMUs.FindingsFindings suggest that PAIs related to clinical research operated under increasing returns to scale between 2002 and 2006. To that extent, both the choice of PAIs as an organizational format and the current growth strategy at the Institute may be considered adequate.Originality/valueThis approach is valuable to complement the cost minimization analysis of specific activities of multipurpose organizations and has general application to the overall assessment of performance, structures and strategies in these organizations.