Measuring the effect of deprivation on primary health care performance using data envelopment analysis and Malmquist Indices

Life expectancy is typically shorter in areas with higher deprivation, highlighting the need for policymakers and health care managers to focus on reducing health inequalities through efficient and effective care. This study aims to assess the impact of deprivation on primary health care performance using data from the National Health Service (NHS) in England. Two methods are applied: Data Envelopment Analysis (DEA) to evaluate the performance of 188 Clinical Commissioning Groups (CCGs), whose duties were recently taken on by the new Integrated Care Systems (ICSs), and the Malmquist Index (MI) to assess deprivation's effect on performance. The DEA results reveal significant variation among CCGs in equity, efficiency, and effectiveness, indicating substantial room for improvement. The MI results show that while CCGs in more deprived areas had more resources per capita and higher efficiency, they were generally less effective than those in less deprived areas. This emphasizes the need to enhance health and social policies to address persistent health inequalities due to deprivation, a critical challenge for the new ICSs. This study illustrates how DEA and the MI can support policymakers and managers in this effort.