Reforms in the Portuguese health care sector: Challenges and proposals

Nunes, Alexandre Morais; Marques, Rui Cunha

doi:10.1002/hpm.2695

Cited by 27 publications

(39 citation statements)

References 9 publications

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“…The Ministry of Health is responsible for the health sector planning, organization, and regulation. The provision of health care is granted by public entities (primary care centres, hospitals, and continued and palliative care) and complemented by private partners (consultations, diagnostic and therapeutic examinations, hospitals, and other private clinics) (Nunes and Ferreira 2019).…”

Section: Portugal and Its National Health Servicementioning

confidence: 99%

The Unlikely Saviour: Portugal’s National Health System and the Initial Impact of the COVID-19 Pandemic?

2020

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What is the impact of COVID-19 on Portugal’s Serviço Nacional de Saúde (SNS), the country’s national health service? The story, still unfolding, has all the elements of a recipe for disaster: one of the most elderly populations in the world; a weakened SNS, the result of a litany of policies and interventions by the ‘Troika’ (the European Commission, the European Central Bank and the International Monetary Fund); a health care delivery system focused on non-communicable diseases and long-term care; the growing public distrust in public services, compared to private, hotel-like health care facilities. We are aware that these are still the early days of the epidemic, yet it is safe to say that algorithmic scenarios of doom and gloom have so far been averted. In the past six months of the pandemic, the level of trust of the Portuguese population in the SNS and its health personnel has significantly improved, while the government has started to provide additional funding and to work for the expansion of the public system. At the very inception of the pandemic, private hospitals practically closed their doors to COVID-19 patients. Unexpectedly a new disease, COVID-19, by definition the foe of any health system, has granted the opportunity for a rare consensus amongst different key political and/or corporate actors in a long-called-for reform of the SNS. Social science and humanities, with their analytical tools and theoretical-conceptual frameworks, are mandatory in providing well-funded answers to such riddles and better grasping the reasons for the twist and turns.

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Section: Portugal and Its National Health Servicementioning

confidence: 99%

The Unlikely Saviour: Portugal’s National Health System and the Initial Impact of the COVID-19 Pandemic?

2020

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“…In older adults from Korea, it was observed that the low-income status associated with the coinsurance payment policy could trigger a large medication cost burden [26]. To avoid a medication cost burden, the co-payments on Portuguese NHS include exceptions and people with certain medical conditions and older adults with low incomes are exempt from copayment for publicly provided services [27][28][29]. Moreover, the co-payments for medicines ranging from 15 to 90% of co-insurance are applied according to their therapeutic value.…”

Section: Discussionmentioning

confidence: 99%

Health professionals perception and beliefs about drug- related problems on polymedicated older adults- a focus group study

et al. 2021

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Background Polymedicated older patients are at greater risk of suffering from adverse events. For this reason, the detection of both inappropriate polypharmacy and polypharmacy-associated Drug-Related Problems (DRPs) are essential to improve the health and wellbeing of older adults and to reduce healthcare costs. This work aims to explore health professionals’ perceptions and opinions about polypharmacy and the handling of medicines by polymedicated older adults. Methods Thirteen focus groups with 94 health professionals (20 community pharmacists, 40 general practitioners and, 34 nurses) were conducted in primary healthcare centers of the center region of Portugal. Participants were asked to discuss their perceptions and beliefs concerning DRPs in polymedicated older adults. The sessions were audiotaped. After the transcription and coding of focus group sessions, a thematic analysis was done. Results The following four main themes emerged from the 13 focus group sessions: poor compliance and polypharmacy- A perpetuated vicious cycle, organization of the healthcare system, interaction and communication between the health professionals, and strategies to prevent inappropriate polypharmacy. Conclusions The lack of both an efficient network of information and Interaction and communication between Health professionals makes the detection and/ or prevention of polypharmacy in older adults difficult. The implementation of new models to manage and/or prevent polypharmacy based on health professional perception and beliefs is essential to prevent DRPs and improve compliance among older adults.

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“…Public health centres are the gatekeeper of Portugal’s National Health Service (NHS). The NHS is predominantly financed by taxes and some out-of-pocket payments that include co-payment for a wide range of services, though there are income-based exemptions for certain population groups (and certain medical conditions) [ 9 , 10 ]. Older adults with an average salary 1.5 times below the value of the social support index are exempt from co-payment for any publicly provided services [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

Voices of Polymedicated Older Patients: A Focus Group Approach

Plácido

Herdeiro

Simões

et al. 2020

IJERPH

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Polypharmacy in older adults is frequently associated with incorrect management of medicines, which causes drug-related problems and, subsequently, poor health outcomes. Understanding why older adults incorrectly manage their medicines is fundamental to health outcomes, however, it is an issue that remains poorly explored. The aim of this study is to examine older people’s perceptions, attitudes, beliefs, and concerns in the central region of Portugal. Thirteen focus groups with sixty-one older adults taking five or more prescription medicines were conducted to explore older patients’ perceptions and beliefs about and management of their medication. Sampling was conducted until theme saturation had been achieved. Transcripts were coded and data were obtained using the NVivo qualitative data-analysis software programme. Older adults recognise the importance of medicines for ensuring healthy ageing. Owing to a lack of literacy, however, they frequently commit medication mistakes and compromise their health outcomes. Promoting the literacy and empowerment of older patients, as well as strengthening the relationship between health professionals and patients, is crucial when it comes to addressing drug-related problems and improving health outcomes.

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Reforms in the Portuguese health care sector: Challenges and proposals

Cited by 27 publications

References 9 publications

The Unlikely Saviour: Portugal’s National Health System and the Initial Impact of the COVID-19 Pandemic?

The Unlikely Saviour: Portugal’s National Health System and the Initial Impact of the COVID-19 Pandemic?

Health professionals perception and beliefs about drug- related problems on polymedicated older adults- a focus group study

Voices of Polymedicated Older Patients: A Focus Group Approach

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