Technical efficiency of Portuguese public hospitals: A comparative analysis across the five regions of Portugal

Abstract

The present study aims to analyse the efficiency scores of hospital units, with reference to the five Portuguese health administrative regions (North, Centre, Lisbon and Tagus Valley, Alentejo, and Algarve). This paper contextualizes the process of decentralization of health in Portugal (started 1993) as well as the hospitals' corporatization and merging reforms (started 2002). These reforms aimed to meet health care needs by optimizing costs, improving efficiency, and broadening both access and quality in health services. Data envelopment analysis was used to quantify and compare the efficiencies of 27 hospitals heterogeneously distributed by five administrative regions. The results show a large average performance across the country. However, there are regions with scores larger than the national average and others with inferior results. This interregional diversity points towards disparities that deserve special attention from the policymakers and hospital managers.

French Idiosyncratic Health-Care Reforms, Performance Management and Its Political Repercussions

“…In Portugal too, the recession and the need to cut health-care expenditures weakened the decentralized model of health administration. 69 France also strengthened the regulatory arsenal to manage care providers from a central administrative apex and rejected British-modelled public–private partnerships. Another difference is that the divide between the public and private sectors in France is not as strong as in Canada, the UK, or Italy.…”

Avaliação Da Qualidade Do Centro Cirúrgico Na Estrutura, Processo E Resultados

“…Num estudo realizado para avaliar a eficiência de unidades hospitalares em Portugal, com resultados de 27 hospitais, os autores evidenciaram disparidades que deveriam merecer atenção especial dos formuladores de políticas e gerentes de hospitais (16) . Este aspecto também foi evidenciado neste estudo.…”

“…A prestação de cuidados de saúde é feita por serviços de saúde públicos e privados (15) . Em Portugal, existem quatro níveis de cuidados à saúde: 1) primários (voltados à comunidade), 2) secundários (em unidades hospitalares), 3) cuidados pós-hospitalares no processo de reabilitação e 4) cuidados paliativos (16) . As reformas implementadas desde 2011 pelo Ministério da Saúde incluem, entre outras, o fortalecimento dos cuidados hospitalares (15) .…”

The corporatization of healthcare organizations internationally: A scoping review of processes, impacts, and mediators

“…Health systems' receptivity to widespread public management reform aids the implementation of corporatization, "with strongly reforming countries benefitting from the layering and bedding-in of NPM reforms, whereas partial reformers lack the complementary institutional structures capable of realizing such benefits" (Andrews et al, 2019(Andrews et al, p. 1253. Ferreira and Nunes (2018) point to the need for regional health authorities to reduce inequalities in hospital efficiency by supporting "the exchange of experiences between units to maximise the installed capacity in each hospital unit, avoiding some of the inefficiencies recorded" (p. 421). A variety of stakeholders can contribute to English FTs' performance by installing values derived from their different constituencies within hospitals' organizational cultures (Wright et al, 2012).…”

“…Additionally, a survey-based study covered a number of European countries(Andrews et al, 2019). Twenty-two articles used a qualitative design while 10 were quantitative; two papers were review articles(Braithwaite et al, 2011;Erny-Albrecht & Bywood, 2016).The predominant theoretical perspective was NPM, or related ideas of accountability, which informed 12 of the articles(Andrews et al, 2019;Kahancová & Szabó, 2015;Ferreira & Nunes, 2018;Ferreira & Marques, 2015;Mattei et al, 2013;Cruz & Major, 2016;Galetto et al, 2014;Wright et al, 2012;Allen et al, 2012aAllen et al, , 2012bHeins & Parry, 2011;Mosebach, 2009). Other studies concentrated on medical professionalism including impact on status, identity, and involvement in reform(Aldred, 2009;Bush et al, 2009;Falkenberg, 2010;Falkenberg et al, 2009;Hunt et al, 2019;Meghani, 2011;Turner et al, 2011;Turner et al, 2016;Uddin et al, 2020;Waring & Bishop, 2013); analyzed corporatized forms in relation to their environment using contingency or institutional theory or historical analyses(Lindlbauer et al 2016;Konda et al, 2019;Farris & Marchetti, 2017); or took an organizational governance or strategy perspective(Jankura, 2014;Kirkpatrick et al, 2017aKirkpatrick et al, , 2017bLee et al, 2008).…”