This article aims to describe the development trajectory of the concept of efficiency in public administration, more specifically in the area of public health. To achieve this objective, a theoretical essay was carried out, in which a theoretical-analytical argument was developed to guide empirical research in relation to the issue of efficiency in health management. This argument is based on three assumptions: over a century of development of the concept of efficiency in public administration, this concept is still heavily loaded with assumptions from engineering; these assumptions, in turn, are directly connected with principles of neoclassical economics, which underlie neoliberal perspectives applied to public management; and in the health area, the concept of efficiency based only on market economy assumptions is insufficient, needing to be articulated with the concepts of efficacy and effectiveness.