Guerra Mariana, de Souza Antônio Artur, Moreira Douglas Rafael
Federal University of Brasilia.
J Health Care Finance. 2012 Summer;38(4):19-35.
This article describes a proposal for analyzing the performance of public Brazilian hospitals using financial and non-financial rates (i.e., operational rates), and thereby highlights the effectiveness (or otherwise) of the financial management of organizations in this study. A total of 72 hospitals in the Brazilian Unified Health Care System (in Portuguese, Sistema Unico de Saúde-SUS), were selected for accessibility and completeness of their data. Twenty-six organizations were used for the study sample, consisting of entities that had publicly disclosed financial statements for the period from 2008 (in particular, via the Internet) and whose operational data could be found in the SUS database. Our proposal, based on models using the method of Data Envelopment Analysis (DEA), was the construction of six initial models that were later compiled into a standard model. The relations between the rates that comprised the models were based on the variables and the notes of: Schuhmann, McCue and Nayar, Barnum and Kutzin, Younis, Younies, and Okojie, Marinho, Moreno, and Cavalini, and Ersoy, Kavuncubasi, Ozcan, and Harris II. We put forward an enhanced grant proposal applicable to Brazil aiming to (i) confirm or refute the rates that show the effectiveness or ineffectiveness of financial management of national hospitals; and (ii) determine the best performances, which could be used as a reference for future studies. Obtained results: (i) for all financial indicators considered, only one showed no significance in all models; and (ii) for operational indicators, the results were not relevant when the number of occupied beds was considered. Though the analysis was related to only services provided by SUS, we conclude that our study has great potential for analyzing the financial management performance of Brazilian hospitals in general, for the following reasons: (i) it shows the relationship of financial and operational rates that can be used to analyze the performance of these organizations; and (ii) it introduces ranges of these values that can be used as standard for the analysis of Brazilian hospitals.
本文介绍了一项关于利用财务和非财务比率（即运营比率）分析巴西公立医院绩效的提议，从而突出了本研究中各组织财务管理的有效性（或反之）。为了数据的可获取性和完整性，从巴西统一医疗系统（葡萄牙语为Sistema Unico de Saúde - SUS）中总共选取了72家医院。26个组织被用作研究样本，这些实体公开披露了2008年以来（特别是通过互联网）的财务报表，且其运营数据可在SUS数据库中找到。我们基于使用数据包络分析（DEA）方法的模型提出的提议是构建六个初始模型，这些模型后来被整合为一个标准模型。构成模型的比率之间的关系基于以下学者的变量和注释：舒曼、麦丘和纳亚尔；巴纳姆和库津；尤尼斯、尤尼斯和奥科吉；马里尼奥、莫雷诺和卡瓦利尼；以及埃尔索伊、卡武恩库巴西、奥兹坎和哈里斯二世。我们提出了一项适用于巴西的强化拨款提议，旨在（i）确认或反驳那些表明国家医院财务管理有效或无效的比率；（ii）确定最佳绩效，可作为未来研究的参考。所得结果：（i）对于所有考虑的财务指标，只有一个在所有模型中均无显著性；（ii）对于运营指标，在考虑占用床位数时结果不相关。尽管该分析仅涉及SUS提供的服务，但我们得出结论，我们的研究总体上在分析巴西医院财务管理绩效方面具有很大潜力，原因如下：（i）它展示了可用于分析这些组织绩效的财务和运营比率之间的关系；（ii）它引入了这些值的范围，可作为分析巴西医院的标准。
