title: [Primary care: decentralization and efficiency].
abstract: 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 La 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 La 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.
authors.affiliation: Departamento de Economía y Empresa. Universidad de La Rioja. Spain. maria.pinillos@dee.unirioja.es
authors.forename: M
authors.initials: M
authors.lastname: Pinillos
authors.forename: F
authors.initials: F
authors.lastname: Antoñanzas
mesh_terms: D017598:Efficiency, Organizational; D006801:Humans; D011057:Politics; D011320:Primary Health Care / Q000458:organization & administration*; D013030:Spain