Efeitos da solvência orçamentária na eficiência técnica dos serviços de saúde e educação dos grandes municípios brasileiros

Abstract

The idea that public goods and services should be provided in a decentralized manner, with the intention of ensuring that the specific social demands of each locality are met, is advocated by various scholars. In response to the challenges posed by Zafra-Gómez (2010), dilemmas arising from externalities, fiscal imbalances, and other factors demonstrate that administrative and financial capabilities can reflect the quality and efficiency in the provision of goods and services established by local governments. In light of this, this dissertation aimed to investigate the effects of budgetary solvency on the dynamic efficiency of health and education services offered by large Brazilian municipalities. The theoretical foundation for this dissertation was primarily based on the Theory of Financial Condition as the main anchor and, secondarily, the Theory of Fiscal Federalism. The sample consists of the 250 largest Brazilian municipalities measured by population stratified by the Brazilian Institute of Geography and Statistics (IBGE) in 2019, with an analysis period between 2011 and 2019. Through Dynamic Network Data Envelopment Analysis (SBM Dynamic Network DEA), overall efficiency scores and scores for the health and education sectors were extracted. In the second stage of the research, using the Generalized Estimating Equations method, the relationship between budgetary solvency, measured by the cost coverage indicator, and the efficiency of health and education services was investigated. The results pointed to a significant and positive relationship between budgetary solvency and the efficiency of health and education services, revealing that the efficiency of these services in large Brazilian municipalities depends on the quality of budgetary solvency of the government. Finally, it was observed that variables such as per capita debt, per capita GDP, population density, and municipality size also influence the efficiency of public health and education services.