The impact of the financial crisis on human resources for health policies in three southern-Europe countries

Correia, Tiago; Dussault, Gilles; Pontes, Carla

doi:10.1016/j.healthpol.2015.08.009

Cited by 67 publications

(57 citation statements)

References 9 publications

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“…Costs constitute a major barrier to accessing care, although long waiting times also seem important. The latter could be explained by reductions in supply, including cuts to provision of services, and the number of nurses employed [27]. This has placed additional pressure on those providing care, which can be expected to demotivate those who remain.…”

Section: Discussionmentioning

confidence: 99%

“…Although a substantial reduction in pharmaceutical expenditure in Portugal reflects generally successful implementation of policies aimed at introducing clinical guidelines, monitoring systems, compulsory electronic prescriptions and generic substitution in both the public and private sector [27], many patients with chronic conditions seem to have cut down on use of medication for financial reasons. Non-adherence to prescribed medication, including secondary prevention of myocardial infarction, due to inability to afford medicines has already led to documented cases of unplanned readmission of patients in Greece [45] and Spain [46].…”

Section: Discussionmentioning

confidence: 99%

“…Although the number of NHS physicians has increased by 3.8% in the same period [26], their salaries, as well as those of other public servants, suffered cuts between 2011 and 2013, and again in the last quarter of 2014, falling by 3.5% for salaries between D 1500 and D 2000 and up to 10% for salaries above D 4165. The ratio of nurses to physicians, which was already low, declined further between 2008 and 2012, from 1.5 to 1.4 [27]. In addition, government decree 266-D/2012 increased the working week from 35 to 40 h, which helped to cut overtime payments by an average of about 6.1% for physicians and nurses.…”

Section: Effects Of Health Care Budget Cuts On Health System and Accementioning

confidence: 99%

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Effects of the financial crisis and Troika austerity measures on health and health care access in Portugal

Legido‐Quigley

Karanikolos²,

Hernández-Plaza

et al. 2016

Health Policy

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a b s t r a c tAlthough Portugal has been deeply affected by the global financial crisis, the impact of the recession and subsequent austerity on health and to health care has attracted relatively little attention. We used several sources of data including the European Union Statistics for Income and Living Conditions (EU-SILC) which tracks unmet medical need during the recession and before and after the Troika's austerity package. Our results show that the odds of respondents reporting having an unmet medical need more than doubled between 2010 and 2012 (OR = 2.41, 95% CI 2.01-2.89), with the greatest impact on those in employment, followed by the unemployed, retired, and other economically inactive groups. The reasons for not seeking care involved a combination of factors, with a 68% higher odds of citing financial barriers (OR = 1.68, 95% CI 1.32-2.12), more than twice the odds of citing waiting times and inability to take time off work or family responsibilities (OR 2.18, 95% CI 1.20-3.98), and a large increase of reporting delaying care in the hope that the problem would resolve on its own (OR = 13.98, 95% CI 6.51-30.02). Individual-level studies from Portugal also suggest that co-payments at primary and hospital level are having a negative effect on the most vulnerable living in disadvantaged areas, and that health care professionals have concerns about the impact of recession and subsequent austerity measures on the quality of care provided. The Portuguese government no longer needs external assistance, but these findings suggest that measures are now needed to mitigate the damage incurred by the crisis and austerity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Effects Of Health Care Budget Cuts On Health System and Accementioning

confidence: 99%

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Effects of the financial crisis and Troika austerity measures on health and health care access in Portugal

Legido‐Quigley

Karanikolos²,

Hernández-Plaza

et al. 2016

Health Policy

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“…4 A Declaração de Recife veio reafirmar a importância da disponibilidade, acessibilidade, aceitabilidade e qualidade da força de trabalho em saúde para o alcance da cobertura universal. 7 Os médicos são provavelmente o recurso mais dispendioso dos sistemas de saúde nos países de rendimento elevado, 8 representando uma parte significativa dos custos dos serviços públicos e, consequentemente, têm sido alvo de cortes nos orçamentos públicos da saúde. 7 Estudos internacionais mostraram que cortes nos orçamentos da saúde e reduções salariais geram descontentamento na classe médica, que reage emigrando, pedindo a reforma antecipada ou transferindo-se do setor público para o privado.…”

Section: Introductionunclassified

“…7 Os médicos são provavelmente o recurso mais dispendioso dos sistemas de saúde nos países de rendimento elevado, 8 representando uma parte significativa dos custos dos serviços públicos e, consequentemente, têm sido alvo de cortes nos orçamentos públicos da saúde. 7 Estudos internacionais mostraram que cortes nos orçamentos da saúde e reduções salariais geram descontentamento na classe médica, que reage emigrando, pedindo a reforma antecipada ou transferindo-se do setor público para o privado. [9][10][11] Estes fenómenos alteram o mercado de serviços em saúde e afetam potencialmente o acesso da população a estes serviços públicos, 2 num efeito cumulativo à desigual distribuição dos médicos, o que não corresponde às necessidade da procura, segundo alguns autores.…”

Section: Introductionunclassified

A Crise Económica em Médicos do Serviço Nacional de Saúde: Estudo Descritivo das Suas Perceções e Reações em Unidades de Saúde na Região da Grande Lisboa

et al. 2017

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RESUMOIntrodução: Na Europa, a evidência sobre o impacto da crise económica nos médicos ainda é escassa. Este estudo explora perceções, opiniões e estratégias de adaptação à crise económica por parte de médicos do setor público na área da Grande Lisboa em Portugal. Material e Métodos:Um inquérito foi aplicado a 484 médicos, selecionados aleatoriamente, no Hospital de São José de Lisboa (n = 302) e nos agrupamentos de centros de saúde primários de Cascais (n = 96) e Amadora (n = 86). Este trabalho baseia-se na análise estatística descritiva das respostas dadas pelos médicos inquiridos sobre as suas perceções do impacto da crise económica no mercado de serviços médicos (n = 484), das mudanças introduzidas no seu trabalho nos setores público (n = 346) e privado (n = 187), e nas suas intenções de migrar (n = 482). Resultados: Os médicos inquiridos percepcionaram um aumento da procura dos serviços, mas também uma redução de serviços oferecidos no público, relacionando estas situações com a crise e com um aumento da oferta no setor privado. Os médicos reportaram uma diminuição de salário no setor público (-30,5%), e um ligeiro aumento no número de horas de trabalho semanal neste setor (+ 2 horas). As respostas indicaram que a mediana das horas de trabalho e rendimentos no privado mantiveram-se constantes entre 2010 e 2015 (16 horas e €2000 mensais). O ajustamento no estilo de vida foi reportado como a principal consequência da crise. O gosto pela profissão médica, a independência e a flexibilidade do trabalho foram os fatores de alívio mais mencionados. Uma percentagem de 15% dos médicos inquiridos declarou considerar a emigração como uma opção para o futuro. Discussão: Segundo os médicos inquiridos, a crise trouxe mudanças importantes nas suas condições de trabalho e no mercado dos serviços médicos. Conclusão: À redução salarial e às piores condições de trabalho, correspondeu uma resposta baseada na motivação intrínseca da profissão. Palavras-chave: Médicos; Política de Saúde; Portugal; Recessão Económica; Saúde Pública ABSTRACT Introduction: In Europe, scant scientific evidence exists on the impact of economic crisis on physicians. This study aims at understanding the adjustments made by public sector physicians to the changing conditions, and their perceptions on the market for medical services in the Lisbon metropolitan area. Material and Methods: A random sample of 484 physicians from São José Hospital and health center groups in Cascais and Amadora, to explore their perceptions of the economic crisis, and the changes brought to their workload. This paper provides a descriptive statistical analysis of physicians' responses. Results: In connection to the crisis, our surveyed physicians perceived an increase in demand but a decrease of supply of public health services, as well as an increase in the supply of health services by the private sector. Damaging government policies for the public sector, and the rise of private services and insurance providers were identified as game changers for the sector. Physicians re...

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Purchasing medicines for the public sector: Evaluation of the performance of centralised procurement in Portugal

Vogler

Habimana

Haasis

2022

Health Planning & Management

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Objective: The study aimed to evaluate centralised procurement of medicines (CPM) in Portugal.Methods: Data were collected through different methods, including a review of the literature and (procurement) documents and an analysis of selected bids. Thirty-seven faceto-face interviews with representatives of public authorities, users (hospitals and regional health administrations), patient associations and pharmaceutical industry were held in Portugal in Q1/2020. Results: CPM has contributed to improved transparency in processes and governance, to increased equity in access to medicines across the country and to lower workload for some users. The findings of the impact on medicine prices and availability are mixed. The benefits of CPM are undermined by some gaps: Lengthy, bureaucratic processes have resulted in delayed availability of medicines at the beginning of a year and in coping strategies of hospitals such as parallel individual procurements. The list of active ingredients under CPM has not been updated since 2016. The procurement agency does not routinely perform market consultations. Key performance indicators for CPM are lacking. Conclusions: Portuguese policy-makers are urged to develop an updated procurement strategy to provide guidance and clarity on the objectives of CPM, the role of the procurement agency and further authorities and key performance indicators.

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The impact of the financial crisis on human resources for health policies in three southern-Europe countries

Cited by 67 publications

References 9 publications

Effects of the financial crisis and Troika austerity measures on health and health care access in Portugal

Effects of the financial crisis and Troika austerity measures on health and health care access in Portugal

A Crise Económica em Médicos do Serviço Nacional de Saúde: Estudo Descritivo das Suas Perceções e Reações em Unidades de Saúde na Região da Grande Lisboa

Purchasing medicines for the public sector: Evaluation of the performance of centralised procurement in Portugal

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