De la Eficiencia a la Crisis: Inversiones en Salud Pública en los Estados Brasileños Antes y Durante la COVID-19

The primary objective of this study was to evaluate the efficiency of health investments across Brazilian states from 2014 to 2022, encompassing both the pre-pandemic period and the COVID-19 era. A detailed analysis was conducted on the state of Amazonas, one of the most severely impacted by the pandemic. The methodology employed for calculating efficiencies was the Data Envelopment Analysis (DEA) panel method, using the window analysis approach. The results indicate that the Southern and Southeastern regions maintained high efficiency before and during the pandemic, particularly in the Federal District, Minas Gerais, Santa Catarina, and Paraná. Amazonas, initially efficient from 2014 to 2019, experienced a sharp decline with the onset of the pandemic in 2020, leading to a health crisis in Manaus, marked by thousands of deaths and the emergence of the new P.1 variant. Future research should focus on municipal-level analyses to capture the heterogeneity present within each state.