Primary care: decentralization and efficiency
Abstract
Objective: The purpose of this paper is to verify whether the productive performance of health centers in autonomous communities with competence in health care is more efficient than that of the centers under the INSALUD.
Methods: We conducted a comparative analysis of the technical efficiency of 66 health centers in Álava, Navarra and Rioja establishments in autonomous communities, in the year under review (1997), had fully transferred the skills health and whose management centers in the same year, was in the hands of INSALUD. The method used to measure and quantify the efficiency of these centers was data envelopment analysis (EDA).
Results: The contrast of the non-parametric efficiency rates half of health centers in La Rioja, Navarre and Alava revealed no significant differences in the (in) efficiency of schools.
Conclusions: The results obtained from the model of efficiency measurement used did not indicate a greater efficiency in the productive performance of primary care centers.
Keywords: Decentralization. Efficiency. Primary Health Care. Data envelopment analysis.
Summary
Objective: The purpose of this study was to evaluate whether the productive behavior of health centers in autonomous communities with competence in health is more efficient than that among centers belonging to Spanish public health system (INSALUD).
Methods: The technical efficiency of 66 health centers in Alava, Navarre and Rioja was analyzed. Centers in autonomous communities that in 1997 had been granted complete authority from the central government to manage their healthcare services were compared with centers whose administration, in the same year, was still in the hands of INSALUD. The method used to measure and quantify the efficiency of these centers was Data Envelopment Analysis.
Results: Nonparametric contrast of the health centers’ mean efficiency rates revealed no significant differences in the (in) efficiency of centers from Rioja, Navarre and Alava
Conclusions: The results obtained from the model of efficiency measurement used did not indicate that decentralization improves the productive efficiency of primary care centers.
Key words: Decentralization. Efficiency. Primary care. Data Envelopment Analysis.