Measuring the performance of hospitals and developing a ranking of them require models that take into account the different nature of the decision units to compare, especially focusing on measures of productivity and efficiency. This paper proposes the use of a conventional data envelopment analysis (DEA) with input orientation to analyze the technical efficiency of general hospitals in Spain. In addition, a cross-efficiency (X-DEA) model is proposed to obtain a ranking of those hospitals that are considered efficient. This paper also proposes a method to analyze the degree of importance of each of the dimensions considered in the set of efficient hospitals to identify those factors that can be considered critical, so they can be used as a tool for hospital managers in order to establish improvement programs. This issue is particularly relevant nowadays in Spain given the controversy generated in the health sector by government spending cuts.

Key words: hospital performance, health care standards, DEA, Cross-Efficiency..
JEL Classification: I11, I18, C61.