title: [Technical efficiency assessment of public primary care providers in the Basque Country (Spain), 2010-2013].
abstract: OBJECTIVE
  To evaluate the technical efficiency of primary care units operating in the Basque Health Service during the period 2010-2013, corresponding to the implementation of a care integration strategy by health authorities.
  
  
  METHODS
  This study included 11 of the 12 primary care units in the Basque Health Service during the period 2010-2013. Data envelopment analysis (DEA) was used to assess the technical efficiency of the units. In particular, we applied the extension DEA windows to analyse all units as if they were in a single period (33 observations) as well as a conditional model, which allowed incorporation of the effect of the characteristics of the population covered. The outputs considered were a quality index based on fulfilment of different requirements related to primary care delivery and the rate of avoidable hospitalizations (treated as an undesirable output). The inputs used were the number of physicians, the number of nurses and the costs of prescriptions. The morbidity index was included as an exogenous variable.
  
  
  RESULTS
  The results showed that the efficiency of all the units improved during the study period. However, this improvement was not greater in the units incorporated in the integrated healthcare organisation.
  
  
  CONCLUSIONS
  In a context of global transformation of care delivery in the Basque country in the study period, primary care units increased their efficiency. However, this effect was not larger in vertically integrated primary care providers.
authors.affiliation: Departamento de Economía, Universidad de Extremadura, Badajoz, España.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Cordero
authors.affiliation: Deusto Business School, Universidad de Deusto, Bilbao, España. Electronic address: roberto.nuno@deusto.es.
authors.forename: Roberto
authors.initials: R
authors.lastname: Nuño-Solinís
authors.affiliation: Centro de Salud de Astrabudua, Osakidetza, Erandio (Vizcaya), España.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Orueta
authors.affiliation: Departamento de Economía, Universidad de Extremadura, Badajoz, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Polo
authors.affiliation: O+berri, Instituto Vasco de Innovación Sanitaria, Sondika (Vizcaya), España.
authors.forename: Mario
authors.initials: M
authors.lastname: Del Río-Cámara
authors.affiliation: Bioestadística Independiente, Bilbao, España.
authors.forename: Edurne
authors.initials: E
authors.lastname: Alonso-Morán
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D004526:Efficiency; D017598:Efficiency, Organizational; D006801:Humans; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D011787:Quality of Health Care; D013030:Spain
keywords: Atención primaria; Eficiencia organizativa; Innovación organizativa; Integración de sistemas; Organizational efficiency; Organizational innovation; Primary health care; Systems integration