Primary Healthcare Efficiency Assessment Using Panel Data

The objective of this study is to analyze the efficiency of Primary Healthcare Centers (PHCs) within a health district of the Valencian Community (Spain). The methodology employs Data Envelopment Analysis (DEA) with input orientation and variable returns to scale, utilizing panel data spanning a 5-year period (2015–2019). Inputs considered are number of physicians, nurses, and pharmacy costs, while outputs include number of consultations, hospital emergencies, referrals, avoidable hospitalizations, avoidable mortality, prescription efficiency, and the exogenous variable of morbidity. Three models are developed focusing on healthcare activity, outcomes, and both. Results reveal differences in efficiency scores depending on output variables, with certain PHCs consistently efficient or closer to the efficient frontier, while others remain inefficient. The study indicates a general decrease in efficiency levels over the assessed period, particularly notable when only activity outputs are included. Efficiency analysis using DEA proves valuable as a managerial tool for identifying inefficiencies in PHCs, albeit with the need to align assessment objectives with desired outcomes to ensure accurate results.