Financial evaluation of relative efficiency: an analysis in federal university hospitals in Brazil

The limitation of public resources and the complexity of the environment of the Brazilian Federal University Hospitals (FUHs), the main service providers of the Brazilian Unified Health System (SUS), promoted the evaluation of efficiency in a significant evolutionary tool in this environment, in view of its results, which make it possible to ratify decisions for the enhancement of resources and the improvement of solutions in these institutions.To analyze the Brazilian FUHs regarding the relative financial efficiency, particularly in regards to outpatient and hospital assistance of medium and high complexity.It is descriptive research with quantitative approach and collection of documentary (secondary) data. Relative financial efficiency reflects the ability of a FUH to obtain the maximum outputs at the lowest cost. Data were analyzed using the Data Envelopment Analysis software (DEA). The sample was of a census approach, covering the 50 FUHs, in the quinquennium of 2013-2017.(i) DMUs showed a certain uniformity in relation to the total percentage of (in)efficient FUHs yearly, with the exception of 2016; the UHs of UFJF and UFMA, HUWC UFC and HESFA UFRJ were considered efficient throughout the analyzed period; (ii) the DMU considered a "pinnacle of excellence", for demonstrating the best practices, was MEJC UFRN, which was utilized more frequently (62 times) in the five-year period; (iii) Performance parameters were identified, with inefficient DMUs, allowing a visualization of how much is needed and the ideal value for the variables to reach the relative efficiency frontier.In summary, the proposal has relevance in the context of social interest and for the financial impact on Brazilian public accounts, promoting openness to the financial resources that permeate the FUHs, as well as the value of constructing alternatives and tools for optimizing resources and health services under the SUS.