Roque Alfaro Navarro
University of Chile, South America
Abstract Title: Technical and scale efficiency of cancer screening in municipal primary health care in Chile: a Data Envelopment Analysis
Biography: Roque Alfaro Navarro is a sociologist and public health researcher in Chile. He holds a Master in Public Management and Public Policy from the University of Chile and is currently pursuing a Master of Public Health. His research focuses on efficiency and equity in primary health care systems, particularly in cancer prevention and early detection. He has conducted national-level evaluations of municipal health system performance using Data Envelopment Analysis (DEA) and collaborates with public health institutions on health system strengthening and digital health initiatives in rural territories
Research Interest: Cancer is the leading cause of death in Chile, and early detection relies largely on primary health care (PHC) services delivered through municipal health systems. Despite national screening strategies, important territorial inequities persist in screening coverage and diagnostic capacity across municipalities. This study evaluated the technical and scale efficiency of municipal primary health care in Chile in the early detection of breast, cervical, and gastric cancer during 2023–2024. A cross-sectional quantitative study was conducted using Data Envelopment Analysis (DEA). Municipalities were the unit of analysis, representing the performance of municipal PHC systems. Inputs included public financing for screening programs and health workforce resources, while outputs comprised production of mammography, cervical cytology, and diagnostic endoscopy, as well as abnormal screening results. Output-oriented CCR and BCC models were applied to estimate technical and scale efficiency, and an expansion factor quantified improvement potential. Substantial variability in efficiency was observed across municipalities. Dual mammography provision was associated with higher technical efficiency, whereas outsourced diagnostic models showed lower performance. Gastric cancer detection presented the lowest efficiency and widespread inefficiencies across territories. Significant efficiency gaps exist in cancer screening performance across municipal PHC in Chile. DEA combined with expansion factor analysis provides a robust framework to identify best practices and quantify improvement margins, supporting more equitable cancer prevention in primary care systems.