On comparing the performance of primary care providers

In the past few years primary health care has been characterised as central to the development of the National Health Service in the United Kingdom. Furthermore, performance assessment is seen as a way of achieving care of high standards. Performance indicators and targets are being developed to assess primary care providers, and to develop financial incentives. However, the number of studies that have compared the performance of primary care providers is limited and the existing approaches to evaluation are open to improvement.In this paper, we provide a critical review of the studies that have focused on the evaluation of primary health care providers, with particular reference to the use of the non-parametric technique Data Envelopment Analysis. We conclude that most studies focus on structure and outputs, without consideration of outcomes – the ultimate measure of performance – and tend to be of a summative rather than formative nature.