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OECD Reviews of Health Care Quality: Portugal 2015

Raising Standards

image of OECD Reviews of Health Care Quality: Portugal 2015

This report reviews the quality of health care in Portugal, seeks to highlight best practices, and provides a series of targeted assessments and recommendations for further improvements to quality of care. The Portuguese National Health Service has responded well to financial pressure, successfully balancing the twin priorities of financial consolidation and continuous quality improvement. Even in the post-crisis years when GDP fell and health spending declined, improvements in quality of care continued. The need to reduce health spending has been met through a combination of structural reforms, and a well-designed suite of quality initiatives. Reforms around the purchasing and use of pharmaceuticals and medical devices have helped drive down costs, and Portugal has been innovative in how public funds are used to pay providers, increasingly basing payments on quality and efficiency. Important priorities for further work in the Portuguese health system do remain. Portugal will need to improve clinical processes and pathways, particularly in the acute sector. There is still room to improve efficiency, for instance increasing the share of generic drug consumption, and using the Portuguese health workforce more effectively, especially through expanded roles for nurses. Further structural reform is needed with an emphasis on shifting care out of hospitals into less-expensive community settings, and Portugal will also need to reflect on the strategic direction of the primary care system which, following an impressive reform, now risks developing into a two-tiered system with increasingly divergent levels of care quality.

 

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Assessment and recommendations

The Portuguese health system has responded well to financial pressures over recent years, successfully balancing the twin priorities of financial consolidation and continuous quality improvement. Even in the postfinancial crisis years (during which GDP fell from USD PPP 23 860 in 2008 to USD PPP 20 188 in 2012, with health spending falling by 6.7%), ambitious quality improvement efforts were sustained. Avoidable hospital admissions for asthma, COPD and diabetes are amongst the lowest in the OECD and Portugal experienced one of the steepest reduction of ischemic heart disease (IHD) mortality rates in the OECD, more than halving from 116.1 deaths per 100 000 population in 1990 to 51.7 in 2011.

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