Decentralization and Productivity of the Public Health Service in Brazil
Aléssio Tony Cavalcanti de Almeida, Carlos Eduardo Gasparini

Abstract
Most of the scientific literature reveals that the process of fiscal decentralization is a potential inducer of efficiency and productivity in the public sector. However, some authors have questioned whether the process in Brazil would be generating waste of public resources and raising problems in the quality of services provided. This paper utilizes the Malmquist index using Data Envelopment Analysis (DEA) and econometrics with panel data to assess the relationship between fiscal decentralization and productivity performance of the public health service in Brazil, as well as to provide an overview of the dynamics of regional productivity in the sector. The results indicate that the decentralization of health spending has a negative relationship on the productivity of these services, but fiscal responsibility has a greater influence on the performance of the local governments.

Full Text: PDF     DOI: 10.15640/jeds.v2n4a7