There are wide discrepancies between French départements as regards health expenditure. Theproblem for the public authorities is to determine whether these gaps represent differences in health and medical needs or are the consequence of inefficient management of health risks by the various participants in the healthcare system in certain départements. We suggest an estimation of the efficiency of health expenditure in individual départements. Thismeasure of marginal efficiency results from a comparison of the levels of health expenditure taking into account indicators of morbidiTY and of the environment of eachdépartement. WeuseaDEAmodelin order toobtainameasureof managerial efficiencythatallows forexogenousfeaturesof the operatingenvironment. Finally, weshowhowDEAscorescanbeused asayardstick in the interregionalequalisation system.