Abstract
Considering the complex environment of Federal University Hospitals (HUFs) and the decentralization of public services, the objective of this study was delimited in analyzing Brazilian HUFs in terms of relative financial efficiency, by size, geographic region, specialty, contract with Ebserh and type management (outpatient and hospital), based on the perspective of Fiscal Federalism. The study sample was census, covering 50 HUFs during the five-year period from 2013 to 2017. The study has a quantitative approach, using Data Envelopment Analysis (DEA) and analysis of variances (ANOVA) for data analysis. The results showed that the four hypotheses related to efficiency (dependent variable) were accepted, which allowed to corroborate some assertions of the theoretical framework. Specifically, it is accepted that: Smaller HUFs are as efficient as larger ones; Specialty HUFs are just as efficient as general ones; HUFs with a management contract with Ebserh are as efficient as those that do not have e; HUFs that have full municipal management with SUS are as efficient as HUFs that have state or dual management.