Health policies and data

OECD Reviews of Health Care Quality: Portugal 2015

Raising Standards

In series:OECD Reviews of Health Care Qualityview more titles

Published on May 27, 2015

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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.

 

TABLE OF CONTENTS

Foreword and acknowledgements
Executive summary
Assessment and recommendations
Quality of care policies in Portugal
Primary care provision in Portugal
Improving the quality of hospital care in Portugal
Quality and efficiency in Portuguese health care
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PRESS RELEASES

 

 COUNTRY KEY FINDINGS - LESSONS LEARNT


  • The Portuguese National Health Service has responded well to financial pressure, successfully balancing the twin priorities of financial consolidation and continuous quality improvement, and reforms hold lessons for other OECD countries. Portugal’s rich information infrastructure, which covers all system levels, is impressive.

  • More focus on clinical processes, pathways and standards of care is needed, particularly in hospitals, where health care associated infections appear more common than elsewhere (with a reported prevalence of 10.7% of in-patients in 2011/12, compared to 6.0% EU average). Caesarean-section rate is still the fifth highest rates in the OECD although it is falling.

  • Long average lengths of stay after a heart attack, high volumes of non-generic and inappropriate prescribing, and significant variation in medical practice across regions are, however, areas that still need to be addressed.

  • Portugal now needs to reflect on the strategic direction of the primary care system which, following an impressive reform to increase accountability and value-for-money, now risks developing into a two-model system with increasingly divergent levels of care quality.

  • Read the Assessment and recommendations
 OECD Reviews of Health Care Quality: Portugal 2015 - Health Expenditure


For further health expenditure data, go to OECD.Stat

 

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