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.



Primary care provision in Portugal

The primary care system in Portugal appears to be performing well, based on OECD indicators, with some examples of excellence and innovation backed up by a comprehensive national quality indicator system. The fact that the Portuguese health system is already squarely turned towards measuring, assuring and improving quality will give Portugal a major head start in assuring high quality care going forward. The dynamic and innovative nature of the health system, with a number of impressive initiatives in primary care – for example the introduction of Family Health Units, and a very large cachet of quality indicators for primary care – is another significant strength. Looking to the future, Portugal's main priorities will be, firstly, supporting and expanding areas of excellence and innovation, and, secondly, filling in some key gaps, notably around primary care-led prevention the effective use of the primary care workforce.


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