Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-10-02T23:54:53Z No. of bitstreams: 1 FranciscoIranylsonGomesDeBrito_DISSERT.pdf: 2162249 bytes, checksum: 705807d11afddba0f2b504f6e0886a8d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-10-09T21:40:02Z (GMT) No. of bitstreams: 1 FranciscoIranylsonGomesDeBrito_DISSERT.pdf: 2162249 bytes, checksum: 705807d11afddba0f2b504f6e0886a8d (MD5) / Made available in DSpace on 2017-10-09T21:40:02Z (GMT). No. of bitstreams: 1 FranciscoIranylsonGomesDeBrito_DISSERT.pdf: 2162249 bytes, checksum: 705807d11afddba0f2b504f6e0886a8d (MD5) Previous issue date: 2016-11-28 / O presente trabalho prop?e um novo modelo de an?lise da efici?ncia do sistema de sa?de p?blica do Brasil a partir da avalia??o dos gastos na vacina??o dos munic?pios. Considerando que a sa?de funciona de forma interligada entre seus agentes, a efici?ncia de uma forma geral pode ser afetada por problemas de base como a vacina??o na qual contribui para o controle das doen?as transmiss?veis e de morte. Verifica-se, assim, que a imuniza??o pode influenciar na efici?ncia do sistema de sa?de em sua totalidade. ? importante destacar que o m?todo de pesquisa utilizado foi predominantemente descritivo com aplica??o da An?lise Envolt?ria de Dados com modelagem din?mica (Dynamic Data Envelopment Analysis - DDEA) para determinar a efici?ncia das unidades tomadoras de decis?o (DMU) entre os anos de 2013 a 2015. A amostra coletada contempla as regi?es metropolitanas nas quais s?o compostas por 631 munic?pios e Bras?lia visto que a mesma n?o ? considerada munic?pio. Deve-se ressaltar que foram exclu?dos 2 munic?pios da an?lise por n?o apresentarem informa??es suficientes. De acordo com o Minist?rio da Sa?de, as vari?veis que comp?em a modelagem matem?tica s?o classificadas como indicadores de desempenho, e est?o organizadas no modelo conceitual de pesquisa da seguinte forma: inputs (gasto per capta com sa?de e percentual aplicado com gasto profil?tico e terap?utico); carry ? over (percentual de cobertura de vacina??o) e outputs (percentual aplicado com assist?ncia hospitalar, ambulatorial e com medicamentos). Admitindo a grande extens?o territorial do Brasil e suas diferen?as demogr?ficas e socioecon?micas entre as regi?es, a an?lise de dados est? sistematizada em 4 est?gios. No primeiro est?gio, os dados foram rodados e agrupados com todas DMU?s. No segundo, por regi?es. No terceiro por Estados e o ?ltimo por portes dos munic?pios. De acordo com as an?lises realizadas, os resultados apontaram n?veis de efici?ncias distintas em cada est?gio entre as an?lises globais e por per?odos entre os munic?pios. Ainda nas an?lises realizadas por porte de munic?pios o qual ? considerado o maior est?gio de n?vel de homogeneidade da amostra, ? apontado que quanto maior o munic?pio, maior ser? a sua efici?ncia. Este resultado demonstra a import?ncia dos investimentos na sa?de, pois quanto maior o munic?pio, maior ser? sua arrecada??o pr?pria e sua receita corrente l?quida. Dessa forma, haver? um aumento da aplica??o de recursos na sa?de devido a obrigatoriedade legal e, tamb?m, um aumento nos repasses do governo estadual e federal, pois as verbas s?o distribu?das de acordo com o n?mero de habitantes por munic?pio. Contudo, ? importante ressaltar que cabe aos gestores analisar e se espelhar nos relat?rios gerenciais e financeiros dos munic?pios com n?vel de efici?ncia maior para que possam melhorar seu desempenho. / The present work proposes a new model for the analysis of the efficiency of the Brazilian public health system based on the evaluation of the vaccination expenditures of the municipalities. Considering that health functions interconnectedly among its agents, overall efficiency can be affected by underlying problems such as vaccination in which it contributes to the control of communicable diseases and death. Thus, immunization can influence the efficiency of the health system as a whole. It is important to highlight that the research method used was predominantly descriptive with the application of Dynamic Data Envelopment Analysis (DDEA) to determine the efficiency of the decision making units (DMU) between the years of 2013 and 2015. The collected sample contemplates the metropolitan regions in which they are composed by 631 municipalities and Bras?lia since it is not considered a municipality. It should be noted that 2 municipalities were excluded from the analysis because they did not present sufficient information. According to the Ministry of Health, the variables that make up the mathematical modeling are classified as performance indicators, and are organized in the conceptual research model as follows: inputs (expenditure per capita with health and percentage applied with prophylactic and therapeutic expenditure) ; carry - over (percentage of vaccination coverage) and outputs (percentage applied with hospital, outpatient, and medication assistance). Assuming the great territorial extension of Brazil and its demographic and socioeconomic differences between regions, the data analysis is systematized in 4 stages. In the first stage, the data were rotated and grouped with all DMU's. In the second, by regions. In the third by states and the last by ports of the municipalities. According to the analyzes, the results indicated different levels of efficiencies at each stage between the global analyzes and by periods between the municipalities. Still in the analyzes carried out by municipalities, which is considered the highest stage of homogeneity level of the sample, it is pointed out that the larger the municipality, the greater its efficiency. This result demonstrates the importance of investments in health, since the larger the municipality, the higher will be its own collection and its current net revenue. In this way, there will be an increase in the application of resources in health due to legal obligation and also an increase in the transfers of the state and federal government, since the funds are distributed according to the number of inhabitants per municipality. However, it is important to emphasize that it is up to managers to analyze and mirror the management and financial reports of municipalities with a higher level of efficiency so that they can improve their performance.