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Portugal - Portugal: Health system review. 2011

This European Observatory Country Profile provides a detailed description of the health system and of policy initiatives in progress or under development in Portugal. It shows a population that enjoys good health and increasing life expectancy, a health system that has not undergone any major changes on the financing side since the early 1990s, and a steady growth in public health expenditure. The system is financed largely through taxation, but co-payments have been increasing, primarily for pharmaceuticals. Recent measures have aimed to improve performance.

Portugal - OECD Reviews of Health Care Quality: Portugal 2015. Raising Standards

Released by the OECD, this report reviews the quality of Portuguese health care, highlights best practices, and provides a series of targeted assessments and recommendations for improvement. The report describes how Portugal has responded well to financial pressure, successfully balancing financial consolidation and continuous quality improvement.

Portugal - Evaluating Hospital Efficiency Adjusting for Quality Indicators: an Application to Portuguese NHS Hospitals

This working paper by economics researchers at the University of Porto develops methodologies to assess whether there is a trade-off between efficiency and quality in Portugal’s National Health Service. The paper compares two methodologies to compute technical efficiency scores adjusted for quality.

Portugal - Portuguese Health Literacy Action Plan helps people to help themselves

Portugal has initiated a Health Literacy Action Plan to encourage citizen participation in healthcare decisions. The plan focuses on interventions to increase health literacy and enhance peoples' ability to navigate the health service and improve self-care and disease management. Surveys show that 38% of the Portuguese population have poor levels of health literacy.

Portugal - Health system review

Since the 2008 economic crisis, health sector reform in Portugal has been guided by financing agreements between the Portuguese Government and international lending institutions. While measures mainly focus on containing costs and improving efficiency to ensure financial sustainability, this review says significant health inequalities persist and quality and accessibility of care is likely to be negatively affected by continuing budget cuts.

Portugal - The Impact of an Increase in User Costs on the Demand for Emergency Services: The Case of Portuguese Hospitals

There is little evidence on the impact of user costs on demand in public health systems. This study examined the effects of increased user costs on emergency service use without finding any association. A concurrent cancellation of free patient transportation, however, did reduce demand. This finding supports the idea that indirect costs are most important in determining access to public health systems.

International - The Role of Private Non-Profit Healthcare Organizations in NHS Systems: Implications for the Portuguese Hospital Devolution Program

The national health systems of many countries are based on the principle of an integrated public sector payer-provider. However, in some systems private non-profit organizations (NPOs) continue to play a role. This paper compares the international position of NPOs in public health systems with Portugal’s ongoing program to devolve public hospitals to NPOs. Evidence on the Portuguese program suggests it improved efficiency and access without sacrificing quality.

Europe - Competition policy in five European countries. What can be learned for health policy in England?

This Health Foundation working paper is the final report of a project that produced case studies of competition policies in France, Portugal, Germany, The Netherlands and Norway. It finds that patient choice policies are increasingly common, that the process to determine hospital tariffs differs across countries, and that introducing GP competition is controversial.

Europe - Health, health systems and the crisis in six countries

These case studies published by the WHO examine the impact of the 2008 financial crisis on health systems and health in six European countries: Estonia, Greece, Ireland, Latvia, Lithuania and Portugal. The case studies examine how severe fiscal pressures on post-2008 health budgets have pushed policy makers to respond differently.

International - Waiting time policies in the health sector

Examining wait time policies in the 34 OECD countries, this study compares policies in the UK with those in Scandinavia, Portugal, the Netherlands and New Zealand. It discusses the prioritization policies of the UK National Health Service (NHS) and assesses inequalities in waiting times by socioeconomic status across the OECD.

International - Slow growth in health spending but Europe lags behind

Many European countries saw further reductions in health spending in 2013, according to OECD Health Statistics 2015. Health spending continued to shrink in Greece, Italy and Portugal in 2013. Most countries in the European Union reported real per capita health spending below the levels of 2009. Outside of Europe, health spending has been growing at around 2.5% per year since 2010.

International - Urgent action needed to tackle rising inequality and social divisions, says OECD

Society at a Glance 2014, published by the OECD, examines social spending since the economic crisis began in 2008 and finds that Income inequality and social divisions could worsen and become entrenched unless governments act quickly to boost support for the most vulnerable in society. It warns against further across-the-board cuts in social transfers. The number of people living in households without any income from work has doubled in Greece, Ireland and Spain, and risen by 20% or more in Estonia, Italy, Latvia, Portugal, Slovenia and the United States.

International - Can competition reduce quality?

This paper from Portugal’s University of Minho studies competition’s effects on quality in markets such as health care when competition among provider is based on both price and quality. The paper argues that because providers are motivated and risk-averse and because, for given quality levels, fiercer competition results in lower profits due to lower prices, providers will respond by lowering their quality in order to recover some of the lost profits.

Governing public hospitals. Reform strategies and the movement towards institutional autonomy

Brief analytical summaries or syntheses #33 Governing public hospitals. Reform strategies and the movement towards institutional autonomy Summary This study by researchers at the World Health Organization (WHO) explores major developments in the governance of public hospitals in Europe and looks at their implications for national and European health policy. Individual hospitals have been given varying degrees of semi-autonomy within the public sector and have been empowered to make key strategic, financial and clinical decisions themselves. The study includes an in-depth assessment of eight different country models of semi-autonomy. Background For hospital governance to be effective, it must incorporate two powerful and well-developed lines of health sector logic on the one hand, national health policy and objectives; on the other, operational hospital management. One sphere is political, the other technical. One is subjective and value-based, the other is objective, with performance that can be measured both clinically and financially. The…

International - Health systems and the financial crisis

This issue of Eurohealth examines health system responses to the financial crisis in the Czech Republic, Estonia, Greece and Ireland. It also looks at chronic care in Denmark, health insurance competition in The Netherlands and Pharmaceutical reforms in Portugal.

Europe – Efficiency and Health Care

The September issue of EuroHealth explores the possibilities and challenges of developing a workable model of efficiency in European health systems. Articles highlight reforms in the Netherlands and Portugal as well as providing a Europe-wide perspective.

International - Performance Assessment in Primary Health Care: A Systematic Literature Review

This CEFAGE working paper by researchers at the University of Algarve in Portugal provides a systematic literature review of studies devoted to the performance assessment of primary healthcare providers.

Financial sustainability and affordability of health care systems. Lessons from OECD countries

Brief analytical summaries or syntheses #46 Financial sustainability and affordability of health care systems. Lessons from OECD countries Summary This presentation by Mark Pearson, head of the Health Division at the OECD, reviews how health spending has been affected during the economic crisis in various countries. the author makes some recommendations on how policy should react. The presentation was delivered at the International Conference of Social Security Actuaries and Statisticians that took place in Berlin from May 30 to June 1, 2012. Background The problem facing many European health systems is one of fiscal unsustainability. Claims that health spending is good value for money compared to many other things that people purchase are beside the point. Fiscal sustainability needs to be restored in the short term and once this is done, there will still remain the longer-term challenge of ensuring economic sustainability, which requires a different agenda of policies –…

International - International responses to austerity

Undertaken to support the report, “More than Money: closing the NHS quality gap”, this evidence scan provides information on austerity and health care from an international perspective. The scan uses a case study approach to examine health system policy responses to financial crises in six countries: Canada, Denmark, Ireland, the Netherlands, Portugal and Spain.