Eficiencia del sistema de salud chileno: análisis comparativo entre los servicios de salud

Resumen

Background: The assessment of health systems efficiency determines how they use their supplies to produce products of health value. Aim: To determine the efficiency of the health services in Chile, managing their budget to improve the health of the population in 2016. Material and methods: Data envelopment analysis (DEA) was used. The relationship or efficiency with external factors was determined ussing a multivariate analysis. As an input, the operating expense accrued per member of the public health system (National Health Fund, FONASA) was obtained. The years of life potentially lost were used as output. Results: The health services of Chile had an efficiency of 68.8% for constant return and 81.3% for variable return. Sixteen percent of their inefficiency is related to the size of the health service. The most efficient health service was the Metropolitano Sur-Oriente and the least efficient was the Araucanía Norte. Urban health services had more uniform and higher efficiencies than their rural counterparts. The external factors that were associated with a greater efficiency were having lower proportion of rural population, a lower proportion of beneficiaries of the National Health Fund (FONASA), fewer hospital discharges, fewer hospital beds, less poverty calculated by income, and a higher access to drinking water. Conclusions: The size of a health service is a major determinant factor for its efficiency to improve the health status of its beneficiaries.