The overall objective of this study is to analyze the efficiency in the use of resources and thequality of public health in the municipalities of Rio Grande do Norte, from 2004 to 2008. Italso seeks to identify the determinants of municipal inefficiency and measure the productivityof public spending on health. To this end, three methods of analysis are used: the DEA, theMalmquist index and the Tobit regression model. Among other findings, it appears thatmunicipalities considered more inefficient in the measurement of expenditure on health makethe largest expense in this function. On the other hand, from 2004 to 2008, only 13municipalities showed an increase in the productivity of public spending. It is also noted thatmunicipalities considered efficient in quality of health, although having more physical andhuman resources, offer fewer health services to the population. In all, the major determinantsof health spending inefficiencies are the variables: age of the mayor, coalition, populationdensity, literacy race and budget revenues. Regarding the inefficiency of the health quality,variables such as: coalition, literacy race have strong influence on this behavior. Thereby, thehypotheses proposed by the study have been fully accepted. In other words, for the efficiencyof the quality and health spending it is needed more than resources, i.e., the expenditureshows itself as essential, but not enough, for political and economic aspects also interferewith the performance of spent and in the quality of health care offered to the population
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