Diferencias estatales y regionales en la eficiencia de los recursos públicos en el sector salud en México

• Autores: Edson Valdés Iglesias, Christopher Cernichiaro Reyna, Marco Antonio Méndez Salazar
• Localización: Contaduría y administración, ISSN 0186-1042, ISSN-e 2448-8410, Vol. 71, Nº. 3, 2026, págs. 1-28
• Idioma: español
• Títulos paralelos:
  • State and regional differences in the efficiency of public resources in the health sector in Mexico
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    El objetivo de esta investigación es determinar la eficiencia de los recursos públicos invertidos en salud a nivel estatal en México durante el periodo de 2001 a 2022, justificado pues uno de los propósitos de la descentralización del gasto público fue mejorar la calidad y la disponibilidad de los servicios. Si bien las regiones y entidades federativas tienen características que las vuelven heterogéneas, una gran parte de la literatura señala que la influencia de los recursos públicos sobre la salud de la población suele ser positiva;

    en contraste, otros estudios enfatizan que dichos efectos no son significativos, e incluso empeoran los resultados de los indicadores en salud. Por esta razón, se analizan la productividad, la eficiencia técnica y el cambio tecnológico a través de los índices de Malmquist y de Hicks-Moorsteen, los cuales permiten observar diferencias regionales. Además, los resultados obtenidos sugieren una pérdida generalizada de eficiencia a lo largo del periodo de estudio

  • English

    The objective of this research is to determine the efficiency of public resources invested in health at the state level in Mexico during the period from 2001 to 2022; such an objective is justified because one of the purposes of the decentralization of public spending was to improve the quality and availability of services. Although regions and states have characteristics that make them heterogeneous, a large part of the literature indicates that the influence of public resources on the health of the population is usually positive; contrastingly, other studies emphasize that these effects are not significant, and even worsen the results of health indicators. For this reason, the Malmquist and Hicks-Moorsteen indices were used to analyze the productivity, technical efficiency, and technological change in the health sector, showing regional differences. Furthermore, our results suggest a pervasive loss of efficiency throughout the period studied

• Referencias bibliográficas
  • Afonso, A., & St. Aubyn, M. (2005). Non-parametric approaches to education and health efficiency in OECD countries. Journal of Applied...
  • Alexander, C. A., Busch, G., & Stringer, K. (2003). Implementing and interpreting a data envelopment analysis model to assess the efficiency...
  • Asandului, L., Roman, M., & Fatulescu, P. (2014). The efficiency of healthcare systems in Europe: A data envelopment analysis approach....
  • Berger, M. C., & Messer, J. (2002). Public financing of health expenditures, insurance, and health outcomes. Applied Economics, 34(17),...
  • Bhat, V. (2005). Institutional arrangements and efficiency of health care delivery systems. The European Journal of Health Economics, 6, 215-222....
  • Crémieux, P., Ouellette, P., & Pilon, C. (1999). Health care spending as determinants of health outcomes. Health economics, 8(7), 627-639....
  • Diewert, W. (1992). Fisher ideal output, input, and productivity indexes revisited. Journal of Productivity Analysis, 3(3), 211-248. https://doi.org/10.1007/BF00158354
  • Dieleman, J., Templin, T., Sadat, N., Reidy, P., Chapin, A., Foreman, K., Haakenstad, A., Evans, T., Murray, K. & Kurowski, C. (2016)....
  • Everitt, B., Landau, S., Leese, M., & Stahl, D. (2011). Cluster Analysis (5th Ed.). England: John Wiley & Sons. https://doi.org/10.1002/9780470977811
  • Farantos, G., & Koutsoukis, N. (2022) Greek health system efficiency and productivity: A window DEA and Malmquist method measurement....
  • Färe, R., Grosskopf, S., Lindgren, B., & Roos, P. (1992). Productivity changes in Swedish pharamacies 1980–1989: A non-parametric Malmquist...
  • Färe, R., Grosskopf, S., Norris, M., & Zhang, Z. (1994). Productivity growth, technical progress, and efficiency change in industrialized...
  • Filmer, D., & Pritchett, L. (1999). The impact of public spending on health: does money matter? Social Science & Medicine, 49(10),...
  • Gavurova, B., Kocisova, K., & Sopko, J. (2021). Health system efficiency in OECD countries: dynamic network DEA approach. Health Economics...
  • Gravelle, H., Sutton, M., Morris, S., Windmeijer, F., Leyland, A., Dibben, C., & Muirhead, M. (2003). Modelling supply and demand influences...
  • Grosskopf, S., Self, S., & Zaim, O. (2006). Estimating the efficiency of the system of healthcare financing in achieving better health....
  • Grossman, M. (2017). On the Concept of Health Capital and the Demand for Health. En Determinants of Health: An Economic Perspective (pp. 6-41)....
  • Gupta, S., & Verhoeven, M. (2001). The efficiency of government expenditure: experiences from Africa. Journal of Policy Modeling, 23(4),...
  • Hadad, S., Hadad, Y., & Simon-Tuval, T. (2013). Determinants of healthcare system’s efficiency in OECD countries. The European Journal...
  • Hicks, J. (1961). The measurement of capital in relation to the measurement of other economic aggregates. En Hague, D. (Ed): The Theory of...
  • Hollingsworth, B., Dawson, P. J., & Maniadakis, N. (1999). Efficiency measurement of health care: a review of non‐parametric methods...
  • Kathuria, V., & Sankar, D. (2005). Inter‐state disparities in health outcomes in rural India: an analysis using a stochastic production...
  • Lacko, R., Hajduová, Z., Bakalár, T., & Pavolová, H. (2022). Efficiency and productivity differences in healthcare systems: the case of...
  • Laporte, A. (2002). A note on the use of a single inequality index in testing the effect of income distribution on mortality. Social Science...
  • López, E. (2012). La descentralización de los servicios de salud. Ars Iuris, 47, 177-203. Disponible en: https://revistas-colaboracion.juridicas.unam.mx/index.php/ars-iuris/article/view/2749/2585...
  • Mohanta, K., Sharanappa, D., & Aggarwal, A. (2021). Efficiency analysis in the management of COVID19 pandemic in India based on data envelopment...
  • Novignon, J., Olakojo, S. A., & Nonvignon, J. (2012). The effects of public and private health care expenditure on health status in sub-Saharan...
  • O’Donnell, C. J. (2010). Measuring and decomposing agricultural productivity and profitability change. Australian Journal of Agricultural...
  • Payne, G., Laporte, A., Deber, R., & Coyte, P. C. (2007). Counting backward to health care's future: using time-to-death modeling...
  • Rahman, M. M., Khanam, R., & Rahman, M. (2018). Health care expenditure and health outcome nexus: new evidence from the SAARC-ASEAN region....
  • Rana, R. H., Alam, K., & Gow, J. (2018). Development of a richer measure of health outcomes incorporating the impacts of income inequality,...
  • Sovilla, B., y Díaz, A. (2022). Del Seguro Popular al Insabi: ¿Por qué recentralizar el gasto público en salud en México? Gestión Y Política...
  • Spinks, J., & Hollingsworth, B. (2009). Cross-country comparisons of technical efficiency of health production: a demonstration of pitfalls....
  • Varabyova, Y., & Schreyögg, J. (2013). International comparisons of the technical efficiency of the hospital sector: panel data analysis...
  • Xu, K., Saksena, P., Jowett, M., Indikadahena, C., Kutzin, J., & Evans, D. B. (2010). Exploring the thresholds of health expenditure for...
  • Zakir, M., & Wunnava, P. V. (1999). Factors affecting infant mortality rates: evidence from cross–sectional data. Applied Economics Letters,...