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Portugal- Health System Analysis

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whitney weber

on 18 February 2013

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Transcript of Portugal- Health System Analysis

1. Health promotion
2. Long Term-Care
3. Primary and Ambulatory Care
4. Hospital Management and Inpatient Care
5. Pharmaceutical Market Portugal A Health System Analysis Setting the Scene Providers Understanding the Workforce

Navigating the System Care Providers Belong to the NHS
"Autonomous Public Hospitals"
Movement away from collective agreements
Civil Servant Status Wide array of licensing arrangements
Quicker and more accessible secondary care Regulation of medical staff and subsequent shortages
Education renovation
Reverse Retirement Shortage of Primary Care
Specialist Recruitment

Financing and Expenditures
Trends and Issues
Future Challenges Complaint Procedure Structure 74% - Central and District Hospitals
20% - Primary Care
3%- Psychiatric Services Health Surveilance and Monitoring
Shared Responisbility 1. Centralized, universal health care system
State-run, single payer NHS covers majority of citizens

2. "Subsystems": employer-based insurance schemes (25%)

3. Private Insurance (10%) Trends and Issues Primary Care Provision and Resources

Pharmaceuticals and Regulation

Economic and Social Challenges Socialized Medicine Good or Bad? Financing and Expenditure Patient Rights in the System - Patient has obligation to follow all the health care
delivery system's rules
- Patient has a duty to actively avoid unnecessary expense under the NHS 1. redesign and autonomy of the health care centres
2. implementation of the USFs
3. restructuring of the public health services
4. other dimensions of intervention in the community
5. implementation of the local health units
6. development of human resources
7. development of the IT system. Task Force for Primary Health Care Geographic Service Areas NHS funded through general taxation
-"Subsystems" funded by employee and employer contributions

11% of GDP
-Government Spending per capita: $1612.75

31.9% of all health expenditures comes from private payors Misuse of Emergency Resources 112 Numbers in Context United States: 17.9% of GDP
-Government Spending Per Capita: $4436.61

46.9% of all health expenditures comes from private payors Works in conjunction with primary care
Offers few specialty services
Very few in operation Spain: 9.5% of GDP
-Government Spending Per Capita: $2099.10

27.2% of all health expenditures comes from private payors In Theory In Practice NHS operates within an annual global budget for health spending.

NHS benefits include all necessary inpatient and outpatient health care services.

Equal access to NHS health services is available to all Portuguese residents (including legal and illegal immigrants) NHS regularly exceeds this budget by a wide margin, and requires supplemental funding

Services such as dental care, or rehabilitation therapy are seldom provided

Informal and/or socioeconomic barriers (especially for illegal immigrants) Pharmaceutical Industry Price and Entry Liberalization
Decriminalization of Elicit Drugs
Spending Cuts and Reductions in R&D 5 Areas of Intervention 3 Coexisting Systems Centralized Planning and Regulation Allocates Global Budget to many institutions within the NHS
-Public Hospitals

Allocates funds regionally on basis of historical expenditure and capitation
-Pays for primary care and special programs Decentralized Management and Policy Implementation Management of NHS is at regional level

Health administration board in each of the 5 regions
1. Strategic management of population health
2. Supervision and control of hospitals
3. Management of primary care/ NHS primary care centers
4. Implementation of national health policy objectives Recent Reforms and Areas for Continued Improvement Overview Introduction: General Background Population: 10.6 million (est. 2011)
-4.1 % of resident population are legal immigrants
-High numbers of illegal immigrants
Aging population

Relatively low levels of urbanization

2000-2009: Recession
-very low, sometimes negative growth

Improving health indicators Sub-System Insurance Private Insurance Public Insurance ? Key Health Indicators Comparison Patient Patient Rights in the System
Geographical Areas/Resources
Complaint Procedure Sources Barros, P. P., Machado, S. R., & Almedia Simoes, J. (2011). Portugal: Health system
review. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0019/150463/e95712.pdf

Simões, J. (2012, 04). The portuguese health care system: Successes and
challenges. Retrieved from http://www.medical.siemens.com/siemens/en_GB/rg_marcom_FBAs/files/brochures/magazin_medsol_2012_02/MedSol_2012_2_Essay_Portugal.pdf

Szalavitz, Maia. Drugs in Portugal: Did Decriminalization Work? (2009) Retrieved

Monitor International. Portugal Pharmaceuticals and Healthcare Report.
(2013) Retrieved from: http://www.marketresearch.com/Business-Monitor

World health statistics 2012. (2012). Retrieved from
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