[Are the indicators used to measure efficiency in primary care adequate?]. / Son adecuados los indicadores que se utilizan en atención primaria para medir la eficiencia?

OBJECTIVE: Getting to know the opinion of area managers and Primary Health Care Facilities coordinators about the indicators used to measure the PHC output. DESIGN: Questionnaire via mail. Descriptive statistics. SETTING: Areas 2-5, and 3, Zaragoza, Spain. PATIENTS: Managing teams of these three areas and Primary Health Care facilities coordinators. MEASUREMENTS AND MAIN RESULTS: The questionnaire was sent to 57 Primary Health Care Facilities coordinators and 16 area managers which was answered 53% of them. In the range from 1 to 10 the so-called product achieved in the evaluation the highest marks have been: the Services offered by the PHCF (7.8), Coverage (7.8), Achievement of the Minimal Technical Rules (7.76) and Patient Satisfaction (7.51). The indicator that obtained the highest level of agreement was also the product achieved in the evaluation of the Services offered by PHCF. CONCLUSIONS: According to these results indicators normally used, related with number of visits are questioned by the professionals. Synthetic indexes recently introduced obtained better values.

[Evaluation of the efficiency of primary care centers. Application of data analysis]. / Evaluación de la eficiencia en centros de atención primaria. Una aplicación del análisis envolvente de datos.

BACKGROUND: One of the major difficulties in evaluating the efficiency of Primary Medical Centres is that of integrating quantitative and qualitative data. METHODS: This study applies the Involved Data Analysis (DEA) for the purpose of evaluating the efficiency of Primary Medial Centres located in the Province of Zaragoza (Spain). DEA is a lineal programming technique that provides information on the relative efficiency of each unit, as compared to all other units. Output such as doctors and nursing services as well as variables relating to the quality of service, and input (personnel and pharmaceutical expenses) referring to 1994, were obtained from Area Management. RESULTS: Without taking qualitative variables into account, only 13 Primary Medical Centres reached maximum efficiency level 1. with a range of 0.53 to 1. Taking quality variables into account, 24 units reached optimum efficiency, with a range of 0.61 to 1. CONCLUSIONS: DEA is a useful tool for both qualitative and quantitative overall evaluation of input and output and identifies units that are inefficient as compared to others. Despite the difficulties involved, the method appears to be beneficial for management as a complementary aid to currently used techniques.