DEA-Like Efficiency Ranking of Regional Health Systems in Spain

The last decades have witnessed an increasing international concern in assessing how efficiently health care resources are used in producing health. At a country level, comparing the efficiency of regional health systems and ranking the regions accordingly promotes transparency policies and represents an important incentive for the design and implementation of specific programs aimed at improving the quality of health care services within the country. The use of data envelopment analysis (DEA) as a tool for efficiency analysis in the health sector is well-established, but its use with a ranking purpose is discouraged due to lack of discrimination and comparability issues. Using data from the competent health authority in Spain, the purpose of this study is to assess the efficiency of the regional health systems in Spain and identify those regions that are using their health care inputs more efficiently than others, given the observed level of health outcomes. To this aim, a DEA-based model that operates under a common weights basis is used in order to improve discrimination and establish a common scale for a proper comparison of the regional health systems in Spain that can be subsequently ranked by their efficiency score.