<![CDATA[Health budget efficiency is an important issue in decentralized public finance, particularly in ensuring that local government spending produces optimal health outcomes. This study analyzes the technical efficiency of health budget utilization in 35 regencies/municipalities in Central Java Province during the 2019–2021 period. The study employed an input-oriented CCR model of Data Envelopment Analysis (DEA). The input variables consisted of health budget realization, the number of doctors, and the number of healthcare facilities, while the output variables included life expectancy, maternal mortality rate, and infant mortality rate. Since maternal and infant mortality rates are undesirable outputs, both indicators were transformed using reciprocal values to conform to the DEA output orientation. The data were obtained from local government financial reports, the Central Java Provincial Health Profile, and publications of Statistics Indonesia (BPS). The findings show that the average technical efficiency scores were 0.904 in 2019, 0.914 in 2020, and 0.903 in 2021. Fourteen regions consistently achieved full efficiency throughout the study period, while others experienced fluctuating or declining efficiency scores. These results indicate that health budget efficiency is not solely determined by the size of budget allocation, but also by governance quality, resource management, and regional capacity in transforming inputs into health outcomes. Policy efforts should focus on strengthening health workforce allocation, improving health information and service management systems, and implementing performance-based budgeting.]]>
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