Measuring technical efficiency in primary health care: the effect of exogenous variables on results.

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 Spanish region of Extremadura.