Eficiência dos gastos em saúde no SUS: uma análise interfederativa com base em indicadores de resultado (2019-2024)

Yana Lobo da Rosa Pallaoro; Carlos Eduardo Gasparetto; Valmir Dal Mass Júnior; Pedro Ferreira Azevedo; Teo Rocha  Campos; Rafaela Zell; Laura de  Ross Rossi

Authors

Yana Lobo da Rosa Pallaoro Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) – Porto Alegre (RS), Brasil. https://orcid.org/0000-0002-3733-5707
Carlos Eduardo Gasparetto Universidade Luterana do Brasil (Ulbra) – Canoas (RS), Brasil.
Valmir Dal Mass Júnior Universidade Luterana do Brasil (Ulbra) – Canoas (RS), Brasil. https://orcid.org/0009-0005-8262-5956
Pedro Ferreira Azevedo Universidade Luterana do Brasil (Ulbra) – Canoas (RS), Brasil.
Teo Rocha Campos Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) – Porto Alegre (RS), Brasil.
Rafaela Zell Universidade Luterana do Brasil (Ulbra) – Canoas (RS), Brasil.
Laura de Ross Rossi Universidade Luterana do Brasil (Ulbra) – Canoas (RS), Brasil. https://orcid.org/0009-0000-7701-4580

Keywords:

Health financing, Unified Health System, Efficiency. Public administration. Health management., Health indicators, Policy evaluation

Abstract

This study assesses the efficiency of public health expenditures across Brazilian federative units between 2019 and 2024, using publicly available secondary data. Financing indicators, Unified Health System (SUS) infrastructure, and health outcomes were analyzed, with particular emphasis on the rate of hospitalizations due to primary care-sensitive conditions (HPCSC). Monetary values were adjusted to 2024 BRL and per capita indicators were derived. Relative efficiency was estimated through the residuals of linear models of HPCSC rates as a function of selected inputs (per capita expenditure, hospital beds, and health professionals per inhabitant). Due to possible underreporting of HPCSC in 2019, inferential analyses focused on the 2020–2024 period. Results reveal structural disparities across states and real growth in expenditure, with heterogeneous performance in outcome indicators. Minas Gerais and the Federal District showed better adjusted performance, while states in the North region demonstrated lower relative efficiency. It is concluded that adjusted efficiency assessment is a useful tool for guiding equitable resource allocation and supporting evidence-informed decisions within the SUS.