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Competition policy for health care provision in Portugal

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  • Barros, Pedro Pita

Abstract

We review the role of competition among healthcare providers in Portugal, which has a public National Health Service (NHS) at the core of the health system. There is little competition among healthcare providers within the NHS. Competition among NHS primary care providers is hindered by excess demand (many residents in Portugal do not have a designated family doctor). Competition among NHS hospitals has been traditionally limited to cases of maximum guaranteed waiting time for surgery being exceeded. The Portuguese Competition Authority enforces competition law. It has focused on mergers between private hospitals and abuse of market power (including cartel cases) by private healthcare providers. The Healthcare Regulation Authority produced several reports on particular areas of activity by private healthcare providers. The main conclusion of these reviews was lack of conditions for effective competition, with the exception of dentistry. Within the NHS, the use of tendering procedures was able to create “competition for the market” in particular areas though it was not problem free. Details in the particular design adopted matter a lot.

Suggested Citation

  • Barros, Pedro Pita, 2017. "Competition policy for health care provision in Portugal," Health Policy, Elsevier, vol. 121(2), pages 141-148.
    • Handle: RePEc:eee:hepoli:v:121:y:2017:i:2:p:141-148
    DOI: 10.1016/j.healthpol.2016.12.005
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    References listed on IDEAS

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    1. João Amador & Ana Cristina Soares, 2018. "Competition in the Portuguese economy: insights from a profit elasticity approach," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 45(2), pages 339-365, May.
    2. Mónica Duarte Oliveira & Carlos Gouveia Pinto, 2005. "Health care reform in Portugal: an evaluation of the NHS experience," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 203-220, September.
    3. Pedro Pita Barros & Werner B. F. Brouwer & Sarah Thomson & Marco Varkevisser, 2016. "Competition among health care providers: helpful or harmful?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(3), pages 229-233, April.
    4. Helena, Ricardo, 2016. "Cross-border healthcare directive: Assessing stakeholders’ perspectives in Poland and Portugal," Health Policy, Elsevier, vol. 120(4), pages 369-376.
    5. Ricardo Gonçalves & Pedro Pita Barros, 2013. "Economies of scale and scope in the provision of diagnostic techniques and therapeutic services in Portuguese hospitals," Applied Economics, Taylor & Francis Journals, vol. 45(4), pages 415-433, February.
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    Cited by:

    1. Rita Bastião & Nuno de Sousa Pereira, 2020. "Performance in the Delivery of Primary Health Care Services: A Longitudinal Analysis," CEF.UP Working Papers 2002, Universidade do Porto, Faculdade de Economia do Porto.
    2. Simões, J. & Augusto, G.F. & Fronteira, I., 2017. "Introduction of freedom of choice for hospital outpatient care in Portugal: Implications and results of the 2016 reform," Health Policy, Elsevier, vol. 121(12), pages 1203-1207.
    3. Lu, Liyong & Pan, Jay, 2019. "The association of hospital competition with inpatient costs of stroke: Evidence from China," Social Science & Medicine, Elsevier, vol. 230(C), pages 234-245.
    4. Pereira, Miguel Alves & Figueira, José Rui & Marques, Rui Cunha, 2020. "Using a Choquet integral-based approach for incorporating decision-maker’s preference judgments in a Data Envelopment Analysis model," European Journal of Operational Research, Elsevier, vol. 284(3), pages 1016-1030.
    5. Siciliani, Luigi & Chalkley, Martin & Gravelle, Hugh, 2017. "Policies towards hospital and GP competition in five European countries," Health Policy, Elsevier, vol. 121(2), pages 103-110.
    6. Ferreira, D.C. & Marques, R.C., 2021. "Public-private partnerships in health care services: Do they outperform public hospitals regarding quality and access? Evidence from Portugal," Socio-Economic Planning Sciences, Elsevier, vol. 73(C).
    7. Pereira, Miguel Alves & Marques, Rui Cunha, 2022. "Is sunshine regulation the new prescription to brighten up public hospitals in Portugal?," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    8. Liyong Lu & Jay Pan, 2021. "Does hospital competition lead to medical equipment expansion? Evidence on the medical arms race," Health Care Management Science, Springer, vol. 24(3), pages 582-596, September.

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