The objective of this study was to measure the efficiency of public hospital expenditures in all Brazilian capitals from 1998 to 2016. More specifically, it obtained the average of the Input Index, Social Welfare Index and the Public Expenditure Efficiency Index with hospital health in the capitals of Brazil, from 1998 to 2016. Afterwards, it measures the influence of the Pact for Health in the Public Expenditure Efficiency Index in hospital health, from the municipality of Rio de Janeiro compared to the other capitals of the country. To obtain the Indexes, it was necessary to use statistical treatment denominated Standardized Score by the Normal Accumulated Distribution Function Method. In order to measure the effects of the Pact for Health on the Public Expenditure Efficiency Index in hospital health was used the econometric model of Differences in Differences with Polygonal Adjustments. The best performance of the Expenditure Efficiency Index hospital was achieved by the municipalities of Boa Vista, Macapá and Porto Velho. The municipality of Rio de Janeiro worsened the quality of public spending on hospital health compared to other capitals after the implementation of the Pact for Health in 2006.