Benchmarking analysis in the health sector: the case of the Community of Madrid 2016–2018

Purpose - This study provides new results on the efficiency on health centers in Madrid (Spain). Design/methodology/approach - The objective of this study was to analyze the efficiency of primary care centers in the Community of Madrid in the period 2016–2018. Special attention has been paid to the detailed study of the best practices carried out. Likewise, the factors affecting efficiency have been analyzed. The methodologies used were nonparametric DEA radial, nonradial and bootstrap, for the estimation of efficiency. The main results reveal that, despite the differences in the techniques used, fundamentally the radial versus non-radial criterion, the results dynamically show the deterioration of the efficiency of the health Centers of the Community of Madrid, when compared by subperiods 2017/18–2016/17. The benchmark analysis identified the best practices of the health centers in the period analyzed. The application of cluster analysis, through kernel distributions (Azzalini and Menardi, 2014), segments the sample in two, and shows the top 20% of health Centers in resource management, in the case of radial DEA. Subsequently, a detailed analysis using pairwise comparison and their presence in the formation of the production frontier captures the benchmark health Centers, as they are present in the three years analyzed in the formation of the production frontier. The analysis of the second stage reports that the explanatory factors of efficiency are centered on the inverse relationship between the population assigned to the health Centers and positively with teaching versus those that do not. It also confirms the extent to which the pressure of care compromises the efficiency of the health Centers. Findings - A methodological approach based on three efficiency analysis methodologies (radial, non-radial and bootstrap) is applied. Likewise, a cluster analysis criterion is used (Azzalini and Menardi, 2014), little explored in the field of Healthcare. Originality/value - The Benchmark analysis applied in this study could contribute to decision making for managers, professionals, and policy makers in the health sector. The provision of a greater quantity and quality of public health resources is an important challenge that must be met in order to maintain levels of excellence.