Trade-off Custo-Qualidade na Provisão de Saneamento Básico no Brasil

Abstract

This article investigated the hypothesis of the existence of a cost-quality trade-off in the provision of basic sanitation services (water supply) in Brazilian municipalities, which can be accentuated by private providers and mitigated by hybrid providers. For this, panel estimates were obtai-ned with municipal data from 2008 to 2015. Hospital morbidity indicators were considered as proxies for non-contractable quality. Mixed capital companies and public companies were considered as of hybrid provision. The results signaled the existence of a cost-quality trade-off, with hybrid providers attenuating it, but not being accentuated by private providers; that is, privatization does not exacerbate the problem. The results also suggested that the trade-off is associated with regional providers. Therefore, the evidence found indicates the importance of mechanisms, such as effective regulatory oversight, that deal with the negative quality (health) response to cost reductions regardless of governance, given that the cost-quality trade-off is observed in public and hybrid providers.