Across the six key categories, San Francisco ranked highest in health and lowest in economy.
San Francisco is the worst-run city of the 149 biggest in the U.S., according to a new ranking of their operating efficiencies.
Nampa, Idaho, Lexington-Fayette, Kentucky and Nashua, New Hampshire finished first, second and third, respectively. Chattanooga, Tennessee and New York City finished just ahead of San Francisco. The City ranked 12th overall for quality of services, but the operational efficiency score was dragged down when service quality was measured against San Francisco's per-capita spending.
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