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Abstract Organ transplant is one of the best options for many medical conditions, and in many cases, it may be the only treatment option. Recent evidence suggests, however, that the COVID-19 pandemic might have detrimentally affected the provision of this type of healthcare services. The main purpose of this article is to use Data Envelopment Analysis and the Malmquist Index to assess the impact that the pandemic caused by the novel coronavirus SARS-CoV-2 had on the provision of solid organ transplant services. To this purpose, we use three complementary models, each focusing on specific aspects of the organ donation and transplantation process, and data from Brazil, which has one of the most extensive public organ transplant programs in the world. Using data from 17 States plus the Federal District, the results of our analysis show a significant drop in the performance of the services in terms of the organ donation and transplantation process from 2018 to 2020, but the results also indicate that not all aspects of the process and States were equally affected. Furthermore, by using different models, this research also allows us to gain a more comprehensive and informative assessment of the performance of the States in delivering this type of service and identify opportunities for reciprocal learning, expanding our knowledge on this important issue and offering opportunities for further research.

Primary Health Care (PHC) is intended to provide a comprehensive response to the patients' health needs. Considering the increasing demand to optimise the use of the available resources while keeping a high-quality standard, it is essential to investigate the health services' performance. We propose a methodology based on the Data Envelopment Analysis (DEA) technique, examining the volume of activities performed and considering the impact of these activities by using a quality indicator directly related to care outcomes. To perform a longitudinal analysis and observe the changes in quality separately, a Quality-Adjusted Malmquist Productivity Index is implemented. The methodology is illustrated by analysing the performance and the evolution in productivity and quality of the primary care services delivered by the municipalities of the Brazilian state of Santa Catarina from 2008 to 2014. Our findings reinforce the view that adequate planning and structuring of PHC services must consider not only the volume of activity but also the impact of the services delivered. info:eu-repo/semantics/publishedVersion