Avaliação da eficiência do Projeto Lean nas Emergências na rede hospitalar do SUS : uma análise integrada utilizando os métodos DEA-SBM e Índice de Malmquist

Abstract

Given the fiscal challenges faced by Brazil and the growing demands of the health sector, it is essential to improve the operational efficiency of the SUS. In this context, the Lean in Emergencies Project has emerged as a strategic initiative aimed at optimizing processes and reducing hospital waste. The aim of this study was to evaluate the project's impact on hospital efficiency, using a quantitative approach based on the combined application of DEA-SBM and Malmquist Index models, based on data extracted from DATASUS. The results indicate that the average technical efficiency of the participating hospitals increased from 0.249 in 2019 to 0.376 in 2023, representing a 51% gain in technical performance. Analysis of the Malmquist Index revealed continuous growth in total productivity, driven mainly by technological advancement (mt = 1.04). In addition, there was a significant reduction in slack in hospital inputs, as in the case of bed management, where the proportion of hospitals with no waste increased from 30% to 54% over the period analyzed. Despite the progress, the data shows that 62.4% of hospitals still operate with technical inefficiency. The regional analysis showed that hospitals in the South and Southeast had the best performance, reflecting greater capacity to adapt to technological innovations and better structuring of processes. The investigation also revealed that smaller hospitals showed greater ability to optimize resources, while larger hospitals, although they showed productivity gains, faced difficulties in aligning technical and operational efficiency. And based on the efficiency observed, it is projected that if the gains achieved by the DMUs were extended to the entire SUS hospital network, the potential annual savings could reach approximately R$3.5 billion. The findings of this research highlight that the continuous adoption of hospital optimization and modernization strategies can contribute to a more sustainable and efficient health system, ensuring better allocation of public resources and expanding access to quality healthcare. Finally, it is suggested that future research should deepen the analysis of the determinants of hospital efficiency, especially by applying fixedeffect models capable of relating socioeconomic variables and indicators to productivity growth.