Efficiency in public health: the trajectory of a concept from engineering

Abstract

This article aims to describe the development trajectory of the concept of efficiency in public administration, more specifically in the area of public  health. To achieve this objective, a theoretical essay was carried out, in which a theoretical-analytical  argument was developed to guide empirical research  in relation to the issue of efficiency in health  management. This argument is based on three  assumptions: over a century of development of the  concept of efficiency in public administration, this  concept is still heavily loaded with assumptions from  engineering; these assumptions, in turn, are directly  connected with principles of neoclassical economics,  which underlie neoliberal perspectives applied to  public management; and in the health area, the  concept of efficiency based only on market economy  assumptions is insufficient, needing to be articulated  with the concepts of efficacy and effectiveness.