Publications IPH Magazine IPH Magazine 13th: Annals Efficiency
- Editorial - 13th
- HEALTH MANAGEMENT: Efficiency, Innovation and Sustainability
- Health Management Focused on Efficiency, Innovation and Sustainability!
- CONGRESS FOR COST AND FINANCIAL MANAGEMENT
- Hospitals, networks and sustainability
- Cost Reduction through Process Review
- Integrating Business Management to the Assistance Management
- International experience on the compensation models
- The Future of Hospital System - The Sustainability Challenge of Small Hospitals
- Advances in Patient Safety: Indicators and Impact on Cost Assistance
- Prospects for Public Private Partnerships and the Partnership Arrangements with Health Social - Critical Analysis of the PPP Brazilian Experiences in Health
- ENGINEERING, ARCHITECTURE AND LOGISTICS CONGRESS
- Hospital Logistics: Intelligence at Service for the Health Manager
- PEOPLE MANAGEMENT AND LEADERSHIP CONGRESS
- Illusionist Performance: Transformation and Innovation in Tough Times
- Implementation Careers & Salaries: New Paradigms and Opportunities
- The Art of Leading Generations X, Y and Z - How to retain talent?
- Giving Back Over the Organizational Climate - Talent Retention Strategies
- Creative Practices to Innovate in HR
- HEALTH MANAGMENT CONGRESS
- Efficiency
- Efficiency (2)
- The Process of Change in Bolivia "Hospital Arco Iris" from Solid Hospital to Liquid Hospital
- PATIENT'S QUALITY AND SAFETY CONGRESS
- Impact of External Assessment in Brazil
- Impact of External Assessment in Brazil (2)
- Quality and impact of patient safety in the hospital financial result - Santa Casa de Misericordia de Maceió
- Quality and Safety Integration on Education Process
- Management
- The Apthapi as Innovation Strategy in the Humanization of Healthcare Hospitality
- The experience of the State Hospital Sumaré / Unicamp in management by care
- HOSPITAL HOTEL CONGRESS
- Hospitality in Patient Perspective
- Hospitality at the Service of Humanization
- Hospitality and Humanization
- Hospitals Infrastructure Trends aimed at Physical and Mental Comfort for Patients and Families
- The Multidisciplinary Integration of Beds Management as a Way to Seek Effectiveness
- Spirituality in Hospitals Focusing on Healthcare Hospitality
Efficiency
Ana Luiza D'Ávilla Viana
Ana Luiza D`Ávila Viana is an economist. She began to study economics at FEA (Faculty of Economics, Management and Accounting) at the University of São Paulo in 1968 and graduated in 1974 at the Faculty of Economics and Political Sciences from Cândido Mendes University in Rio de Janeiro. She completed her master's degree in economics in 1981 and her doctorate in 1994, both at Economics Institute of Unicamp (University of Campinas). She is a retired professor from USP, where she taught from 2002 to 2015 in the Department of Preventive Medicine, School of Medicine. She is a supervisor at the graduate program of this department (supervises currently seven doctoral theses).
In the 2010 WHO report, the issue of efficiency is treated as a priority to achieve universal coverage, as estimates show that 20-40% of all health expenditures are wasted due to inefficiency. Thus, all countries, regardless of their income level, can take steps to reduce inefficiency, which requires an initial assessment of the nature and causes of local inefficiencies. For WHO, efficiency is "a measure of the quality and / or quantity of the products obtained (ie products or health services) for a given level of inputs (i.e. costs). Cetin and Bahce (2016) published a study in which they evaluated the efficiency of health systems in OECD countries, using 7 input variables (number of physicians, number of nurses, number of beds, spending on health per capita, health expenditure in % of GDP, number of MRI devices, tobacco use rate) and 2 variable output (life expectancy at birth and infant mortality). The results showed that the efficiency varies widely across OECD countries and that the most efficient health systems are in Canada, the Czech Republic, Iceland, Ireland, Israel, Japan, Korea, Poland, Slovenia, Sweden and the United Kingdom. Other countries have health systems considered inefficient.
Ozcan and Khushalani (2016) published another study to examine changes in the efficiency of health systems in 34 OECD countries over the period of 2000-2012. Several of these countries (14) carried out reforms in their health systems in this period and the article provides a table where you can see the nature of reforms in each country. The study used a model that separates the health systems into two components: public health (collective actions) and medical care (individual). The results show that countries that have carried out reforms in their health systems had more efficiencies when compared to countries that did not. However, this efficiency gain was mainly due to the public health component. The authors recommend that further efficiency gains could be achieved by reducing the component input medical attention. In an article on the determinants of health system efficiency in Canada, Allin, Grignon and Wang (2015) concluded that the Canadian system has great inefficiencies (range 18-35%), which are the result of three sets of factors: factors related to the management (such as hospital readmissions), factors related to public health (such as smoking and obesity rates) and environmental factors (such as average income in the region). The OECD publication Health Statistics in 2014 - How does Brazil compare? Briefly, the data show that:
- Health spending: health expenditure as% of GDP in Brazil is equal to the average of OECD countries (9.3%). However, in per capita terms, the annual cost is only 1/3 of the average of OECD countries (1109 USD in Brazil, against 3484 USD in the OECD).
- Public vs private: public spending in Brazil is only 46% of the total, way below the average of OECD countries (72%). It is even lower than in the US (48%), Chile (49%) and Mexico (51%), the three OECD countries with the lowest share of public spending.
- RH: Number of physicians per 1,000 citizens was 1.8 in Brazil (in 2010) against 3.2 in OECD (2012). The number of nurses per 1,000 inhabitants is even worse: 1.5 in Brazil (in 2010) against 8.8 in OECD (2012)
- Hospital beds: Brazil had 2.3 beds per 1000 population in 2012, which is less than half the OECD countries' average for the same year (4.8)
- Life expectancy at birth: although Brazil has increased the life expectancy in 19 years since 1960, reaching 73.7 years in 2012, is still 6.5 years below the OECD average (80.2 years)
- Infant mortality: major improvement in the infant mortality rate in Brazil, which fell from 51.6 per 1,000 alive newborns in 1990 to 12.9 in 2012; even so, it is 3 times higher than the OECD average (4.0 per 1000 alive newborns)
- Obesity (a risk factor for many diseases): grew in all countries, but the situation in Brazil (18% of the population) is worse than the average of OECD countries (15%).
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