Comparative Efficiency Assessment of Primary Care Models Using Data Envelopment Analysis

This paper compares the productive efficiencies of four models of primary care service delivery in Ontario, Canada, using the data envelopment analysis (DEA) method. Particular care is taken to include quality of service as part of our output measure. The influence of the delivery model on productive efficiency is disentangled from patient characteristics using regression analysis. Significant differences are found in the efficiency scores across models and within each model. In general, the fee-for-service arrangement ranks the highest and the community-health-centre model the lowest in efficiency scoring. The reliance of our input measures on costs and number of patients, clearly favours the fee-for-service model. Patient characteristics contribute little to explaining differences in the efficiency ranking across the models.