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.
There is a rising concern in OECD countries about the expected growth in the burden of chronic diseases. This project is primarily focused on whether efforts should be made to prevent non-communicable diseases rather than treating and managing them.
La consommation à risque est en augmentation, chez les jeunes et chez les femmes, dans de nombreux pays de l’OCDE, en partie parce que les boissons alcoolisées sont devenues plus aisément disponibles et plus accessibles financièrement, et qu’elles font l’objet de campagnes de publicité efficaces, selon un nouveau rapport de l’OCDE.
OECD insights blog: Francesca Colombo, Head of the OECD Health Division, discusses the issues related to health systems and an ageing population.
The OECD launched a project on “Benchmarking ICTs in health systems”, a multi-stakeholder initiative to improve the availability and quality of health ICT data through the development of a robust measurement framework and comparable cross-national measures. This task was accomplished in 2013 with the publication of an OECD “Guide to Measuring ICTs in the Health Sector”.
The Working Paper sheds light on the extent to which “value” is considered in pricing and/or coverage decisions in 14 OECD member countries. It describes methods used by countries to assess the therapeutic benefits of new products, as well as approaches for economic evaluation, where relevant, and aims to illustrate how value is assessed and what is its impact on pricing and/or reimbursement decisions.
Dementia is a devastating condition for the people affected, their family and friends, and for health systems. Through its global reach and ability to bring together government and non-government perspectives, OECD is in a unique position to face up to the challenge.
L’approche politique actuelle pour lutter contre la démence n’est pas viable socialement et économiquement, selon un nouveau rapport de l’OCDE. Les pays doivent agir immédiatement pour améliorer la vie des personnes atteintes de démence et celle de leurs soignants, donner la priorité à la recherche publique sur la démence, et encourager davantage l’investissement privé dans l’innovation pour la recherche sur la démence.
The large and growing human and financial cost of dementia provides an imperative for policy action. It is already the second largest cause of disability for the over-70s and it costs $645bn per year globally, and ageing populations mean that these costs will grow.
There is no cure or effective treatment for dementia, and too often people do not get appropriate health and care services, leading to a poor quality of life. Our failure to tackle these issues provides a compelling illustration of some of today’s most pressing policy challenges. We need to rethink our research an innovation model, since progress on dementia has stalled and investment is just a fraction of what it is for other diseases of similar importance and profile. But even then a cure will be decades away, so we need better policies to improve the lives of people living with dementia now. Communities need to adjust to become more accommodating of people with dementia and families who provide informal care must be better supported. Formal care services and care institutions need to promote dignity and independence, while coordination of health and care services must be improved. But there is hope: if we can harness big data we may be able to address the gaps in our knowledge around treatment and care.
Dementia is increasing in prevalence, and to date has no cure or treatment. One element in improving this situation is using and sharing data more widely to increase the power of research. Further, moving beyond established medical data into big data offers the potential to tap into routinely collected data from both within and outside the health system.