Journal of Medical Systems

, Volume 35, Issue 4, pp 545–554 | Cite as

Measuring Technical Efficiency in Primary Health Care: The Effect of Exogenous Variables on Results

  • José Manuel Cordero-Ferrera
  • Eva Crespo-Cebada
  • Luis R. Murillo-Zamorano
Original Paper


The aim of this paper is to extend the existing literature about efficiency measurement in primary health care with the application of a recently developed method to deal with exogenous variables. In this context, these variables are represented by the main characteristics of the covered population. The use of this technique allows calculating more accurate efficiency scores that can reflect the performance of units more properly. Our results show that the inclusion of these variables in the evaluation has a great impact on both the values of efficiency scores and the rank of units. This analysis has been carried out using a great amount of data available about primary health care centers in the Spainsh region of Extremadura.


Efficiency DEA Primary Health Care Exogenous Variables 



The authors are most grateful to the Consejeria de Sanidad y Dependencia of the Junta de Extremadura for its financial and data availability support. We also thank Carmelo Petraglia for his helpful assistance in preparing the data set used in the research and to three anonymous referes por for their comments and suggestions.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • José Manuel Cordero-Ferrera
    • 1
  • Eva Crespo-Cebada
    • 1
  • Luis R. Murillo-Zamorano
    • 1
  1. 1.University of ExtremaduraBadajozSpain

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