TY - JOUR ID - 4084 TI - Portuguese Primary Healthcare and Prevention Quality Indicators for Diabetes Mellitus – A Data Envelopment Analysis JO - International Journal of Health Policy and Management JA - IJHPM LA - en SN - AU - Ramalho, Andre AU - Souza, Julio AU - Castro, Pedro AU - Lobo, Mariana AU - Santos, Paulo AU - Freitas, Alberto AD - MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal AD - USF Camélias, ACES Gaia (Grande Porto VII - ARS Norte), Vila Nova de Gaia, Portugal Y1 - 2022 PY - 2022 VL - 11 IS - 9 SP - 1725 EP - 1734 KW - Diabetes Mellitus KW - Health Policy KW - Primary Care KW - Preventable Admission KW - Efficiency KW - Data Envelopment Analysis DO - 10.34172/ijhpm.2021.76 N2 - Background  Diabetes mellitus (DM) is a worldwide public health priority. The increasing prevalence and the budget constraints force to have effective healthcare, especially at the primary healthcare (PHC) level. We aim to assess primary care efficiency considering the best use of human resources to produce optimal diabetes care in terms of prevention quality indicators (PQIs) rates across national ACES (health centre groupings). Methods  We conducted a two-stage data envelopment analysis (DEA) to assess the technical efficiency of 54 Portuguese primary care health centre groupings for the 2016-2017 biennium. In the first stage, efficiency scores were obtained through five output-oriented DEA models under vector return to scale (VRS) assumption, using three input variables representing key primary care human resources and one output representing each one of the five PQIs related to diabetes. In the second stage, Tobit regression models were estimated to assess the determinants of primary care efficiency in diabetes care.Results  A total of 13 ACES reached the efficiency frontier. Better managing human resources could reduce PQI rates by 52.3% in 2016 and 49.1% in 2017. Higher proportion of patients under 65 years old and better controlled with a hemoglobin A1c (HbA1c) ≤6.5% were associated with better efficiency in diabetes care, whereas higher prevalence of DM and unemployment worsened hospitalizations rates by diabetes short-term complications and lower-extremity amputation. Conclusion  Inefficiency in DM care was found in most of the primary care settings which can substantially improve the avoidable hospitalization rates by DM using their current level human resources. These findings help to improve diabetes care by targeting human resources at primary care level, which should be integrated into performance assessments considering broader and integrated scopes. UR - https://www.ijhpm.com/article_4084.html L1 - https://www.ijhpm.com/article_4084_1e374a1615b65b923410cef872d08546.pdf ER -