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Journal of Health Organization and Management· 2026Q2

Multimethod modeling to analyze the relationship between public health efficiency and social determinants management: a longitudinal study in Brazil

Tatiana Marceda Bach, Wesley Vieira da Silva, Augusto César do Nascimento Calista, Victor Diogho Heuer de Carvalho et al.

Short summary

A longitudinal study of 390 Brazilian municipalities found that while federal resource transfers are crucial for public health efficiency, sanitation and financial management indicators are long-term inefficiencies.

AI-generated from the title and abstract; the full text is not read.

Key points

  • Federal government resource transfers are relevant to public health management efficiency in Brazilian municipalities.
  • Sanitation and financial indicators demonstrated long-term inefficiency in impacting public health.
  • A five-phase variable selection process, based on a systematic review of 90 articles, was used to identify key variables.
  • Exploratory factor analysis, data envelopment analysis, and Tobit Regression were employed for analysis.

AI-generated from the title and abstract; the full text is not read.

Abstract

Purpose This study investigates the long-term relationship between management efficiency and representative indicators of the social determinants of public health across 390 municipalities in Paraná, Brazil. Design/methodology/approach The research employed multimethod modeling with a five-phase variable selection process, based on a systematic review of 90 articles that identified 269 variables, reduced to 47 after content analysis and statistical tests. Management efficiency was evaluated using exploratory factor analysis and data envelopment analysis. The effect of efficiency on social health determinants was examined via Tobit Regression, with marginal effects reported. Findings The results demonstrated the relevance of the federal government’s role in transferring resources to municipalities while revealing concerns about sanitation and financial indicators, whose long-term impact proved inefficient. Research limitations/implications The study highlights the need for public policies that optimize the use of federal resources and improve the efficiency of both sanitation and financial management. Limitations include reliance on secondary data and the specificity of the Paraná context, which may limit the generalizability of the results. Practical implications The results offer public managers insights into the importance of resource management efficiency and the need to address sanitation and financial indicators to improve the social determinants of health. Originality/value The research offers a robust methodological criterion for variable selection in public health studies and employs a multimethod approach to examine the relationship between management efficiency and social determinants of health, identifying variables not previously explored in the literature.

The authors' abstract, as published at the source. Journal of Health Organization and Management, 2026 · DOI ↗

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Field: Management Science and Operations Research

Management Science and Operations ResearchDecision Sciences