IMPORTANCE OF CONSIDERING QUALITY INDICATORS IN PRIMARY HEALTHCARE. APPLICATION OF A TWOSTAGE CLUSTER ANALYSIS.

Abstract

The aim of this paper is to evaluate the efficiency and quality of primary healthcare in Extremadura (Spain), assessing at the same time the importance and influence of the quality indicators in the performance of the health units. This analysis considers a series of quality indicators that may affect the efficiency and activity levels of a series of primary care centres. We build different synthetic indices of quantitative output; output adjusted by quality; input, and costs, applying Principal Component Analysis. Using those indices we run several two‐stage cluster analyses. In a first analysis, the output of the health system is obtained from a strictly quantitative point of view and compared to the levels of inputs and costs. In a second analysis, we include an output adjusted by quality to perform such a comparison. The health units in which the region is organised can be clustered in four levels of efficiency and activity: efficientactive, efficient‐inactive, inefficient‐active and inefficient-inactive. The comparison of both analyses highlights the importance of considering qualitative indicators as they substantially influence the efficiency and activity levels of the different primary healthcare centres.