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| Título: | Evaluating factors influencing audit efficacy in Brazilian public hospitals |
| Autor(es): | Pereira, Sofia André |
| Orientador(es): | Garcia, Reinaldo Crispiniano |
| Assunto: | Hospitais
Hospitais públicos
Sistema Único de Saúde (Brasil)
Auditoria hospitalar
Hospitais públicos - auditorias
Hospitais públicos - eficiência |
| Data de apresentação: | 28-Jul-2025 |
| Data de publicação: | 13-Ago-2026 |
| Referência: | PEREIRA, Sofia André. Evaluating factors influencing audit efficacy in Brazilian public hospitals. 2025. 94 f., il. Trabalho de Conclusão de Curso (Bacharelado em Engenharia de Produção) — Universidade de Brasília, Brasília, 2025. |
| Abstract: | This study evaluates the impact of audits on the operational efficiency of Brazilian public
hospitals within the Sistema Único de Saúde (SUS). Drawing on data from January 2019 to
January 2025 for 31 hospitals audited under the “Hospital Efficiency Project,” it measures
changes in efficiency scores eight months before and after each audit. Efficiency was calculated
using a variable‑returns‑to‑scale (VRS) BCC data envelopment analysis (DEA) model,
output‑oriented. Hospitals were clustered monthly by total production value (SIA + SIH values)
to ensure comparability, and four inputs (rooms, beds, doctor hours, nurse hours) and one output
(total production value) were used in the DEA. On average, efficiency improved from 0.80
before audits to 0.81 afterward, with 56.7% of hospitals demonstrating positive gains.
Medium‑sized facilities (26 - 50 beds) and very large hospitals (>300 beds) were most likely to
increase their efficiency, whereas 101-200‑bed hospitals showed net declines. Regional
analysis revealed the Southeast had the highest proportion of hospitals improving (71.4%),
while the Midwest had the lowest (33.3%). Audits conducted by State Courts of Auditors
(TCEs) yielded the greatest average gain (+4.9 percent), in contrast to those by the General
State Comptroller (CGE), which saw a slight decrease (–2.9 percent). Qualitative review of
audit reports uncovered that hospitals with structured internal regulation centers and
standardized performance‑indicator governance translated recommendations into practice more
effectively. These findings suggest that reinforcing data‑quality protocols and tailoring audit
design to hospital size and context could amplify audit effectiveness. Additionally, this study
quantified month‑to‑month production variability - via absolute and normalized Euclidean
distances of SIA + SIH values - and examined its relationship with efficiency behavior,
highlighting that audits stabilized erratic service volumes across different hospital‑size tiers.
The study confirms that well-targeted audits can generate measurable efficiency improvements
in public health systems. |
| Informações adicionais: | Trabalho de Conclusão de Curso (graduação) — Universidade de Brasília, Faculdade de Tecnologia, Departamento de Engenharia de Produção, 2025. |
| Licença: | A concessão da licença deste item refere-se ao termo de autorização impresso assinado pelo autor que autoriza a Biblioteca Digital da Produção Intelectual Discente da Universidade de Brasília (BDM) a disponibilizar o trabalho de conclusão de curso por meio do sítio bdm.unb.br, com as seguintes condições: disponível sob Licença Creative Commons 4.0 International, que permite copiar, distribuir e transmitir o trabalho, desde que seja citado o autor e licenciante. Não permite o uso para fins comerciais nem a adaptação desta. |
| Aparece na Coleção: | Engenharia de Produção
|
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