IDEAS home Printed from https://ideas.repec.org/a/bla/ijhplm/v34y2019i1p196-215.html
   My bibliography  Save this article

The health care reform in Portugal: Outcomes from both the New Public Management and the economic crisis

Author

Listed:
  • Alexandre Morais Nunes
  • Diogo Cunha Ferreira

Abstract

The Portuguese health system concentrates most of its activity in a National Health Service, created in 1979 to promote universal and general access. The National Health Service should ensure equity, efficiency, and quality of all health care delivered services. This study assesses the impact of health care policies between 2002 and 2017, focusing on 3 timeframes: the adoption and adaptation of New Public Management principles to the health care sector (2002 to 2010), the economic and financial crisis period (2011‐2015), and the postcrisis recovery period (2016‐2017). The current study evaluates the main policy measures in the health sector, presenting their impacts in terms of access, efficiency, accountability, and costs over those 3 economic periods. It was verified that not all the measures implemented by the successive governments obtained the desired outcomes, generating even costs increase, apart from the austerity period in which health expenditure showed a significant reduction because of the financial constraints.

Suggested Citation

  • Alexandre Morais Nunes & Diogo Cunha Ferreira, 2019. "The health care reform in Portugal: Outcomes from both the New Public Management and the economic crisis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 196-215, January.
  • Handle: RePEc:bla:ijhplm:v:34:y:2019:i:1:p:196-215
    DOI: 10.1002/hpm.2613
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hpm.2613
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hpm.2613?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Amado, Carla Alexandra da Encarnação Filipe & Santos, Sérgio Pereira dos, 2009. "Challenges for performance assessment and improvement in primary health care: The case of the Portuguese health centres," Health Policy, Elsevier, vol. 91(1), pages 43-56, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Alexandre Morais Nunes & Diogo Cunha Ferreira, 2022. "A Critical Analysis of Decentralizing the Portuguese Public Healthcare Provision Services," IJERPH, MDPI, vol. 19(20), pages 1-10, October.
    2. Ricardo, Alexandre Vilar & Costa, Ana Sara & Figueira, José Rui, 2024. "Enhancing hospital benchmarking: A multidimensional approach to quality assessment in Portugal," Socio-Economic Planning Sciences, Elsevier, vol. 93(C).
    3. Cláudia Costa & Paula Santana, 2021. "Gender and Age Differences in Socio‐economic Inequalities in Total and Avoidable Mortality in Portugal: A Trend Analysis," Fiscal Studies, John Wiley & Sons, vol. 42(1), pages 123-145, March.
    4. Morgan Weiland & Paula Santana & Claudia Costa & Julia Doetsch & Eva Pilot, 2021. "Spatial Access Matters: An Analysis of Policy Change and Its Effects on Avoidable Infant Mortality in Portugal," IJERPH, MDPI, vol. 18(3), pages 1-18, January.
    5. Irene Gabutti & Christian Colizzi & Tommaso Sanna, 2023. "Assessing Organizational Readiness to Change through a Framework Applied to Hospitals," Public Organization Review, Springer, vol. 23(1), pages 1-22, March.
    6. Arantes, Amílcar & Alhais, Andreia Frias & Ferreira, Luis Miguel D.F., 2022. "Application of a purchasing portfolio model to define medicine purchasing strategies: An empirical study," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Luis Murillo-Zamorano & Carmelo Petraglia, 2011. "Technical efficiency in primary health care: does quality matter?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(2), pages 115-125, April.
    2. Cordero Ferrera, Jose Manuel & Alonso Morán, Edurne & Nuño Solís, Roberto & Orueta, Juan F. & Souto Arce, Regina, 2013. "Efficiency assessment of primary care providers: A conditional nonparametric approach," MPRA Paper 51926, University Library of Munich, Germany.
    3. Agovino, Massimiliano & Musella, Gaetano & Scaletti, Alessandro, 2022. "Equilibrium and efficiency in the first aid services market: The case of the emergency department of Sorrento," Socio-Economic Planning Sciences, Elsevier, vol. 82(PB).
    4. Margherita Neri & Patricia Cubi-Molla & Graham Cookson, 2022. "Approaches to Measure Efficiency in Primary Care: A Systematic Literature Review," Applied Health Economics and Health Policy, Springer, vol. 20(1), pages 19-33, January.
    5. Panagiotis Mitropoulos & Kostas Kounetas & Ioannis Mitropoulos, 2016. "Factors affecting primary health care centers’ economic and production efficiency," Annals of Operations Research, Springer, vol. 247(2), pages 807-822, December.
    6. Pelone, Ferruccio & Kringos, Dionne Sofia & Valerio, Luca & Romaniello, Alessandro & Lazzari, Agnese & Ricciardi, Walter & de Belvis, Antonio Giulio, 2012. "The measurement of relative efficiency of general practice and the implications for policy makers," Health Policy, Elsevier, vol. 107(2), pages 258-268.
    7. Nikolaos Oikonomou & Yannis Tountas & Argiris Mariolis & Kyriakos Souliotis & Kostas Athanasakis & John Kyriopoulos, 2016. "Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece," Health Care Management Science, Springer, vol. 19(4), pages 313-325, December.
    8. Thanassoulis, Emmanuel & Silva Portela, Maria C.A. & Graveney, Mike, 2014. "Using DEA to estimate potential savings at GP units at medical specialty level," Socio-Economic Planning Sciences, Elsevier, vol. 48(1), pages 38-48.
    9. 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.
    10. Podinovski, Victor V. & Bouzdine-Chameeva, Tatiana, 2016. "On single-stage DEA models with weight restrictions," European Journal of Operational Research, Elsevier, vol. 248(3), pages 1044-1050.
    11. Silvia González-de-Julián & Isabel Barrachina-Martínez & David Vivas-Consuelo & Álvaro Bonet-Pla & Ruth Usó-Talamantes, 2021. "Data Envelopment Analysis Applications on Primary Health Care Using Exogenous Variables and Health Outcomes," Sustainability, MDPI, vol. 13(3), pages 1-17, January.
    12. Márcia N. F. Manoel & Sérgio P. Santos & Carla A. F. Amado, 2023. "Assessing the impact of COVID-19 on the performance of organ transplant services using data envelopment analysis," Health Care Management Science, Springer, vol. 26(2), pages 217-237, June.
    13. M. C. Gouveia & L. C. Dias & C. H. Antunes & M. A. Mota & E. M. Duarte & E. M. Tenreiro, 2016. "An application of value-based DEA to identify the best practices in primary health care," OR Spectrum: Quantitative Approaches in Management, Springer;Gesellschaft für Operations Research e.V., vol. 38(3), pages 743-767, July.
    14. John Buckell & Andrew Smith & Roberta Longo & David Holland, 2013. "Health inefficiency and unobservable heterogeneity - empirical evidence from pathology services in the UK National Health Service," Working Papers 1307, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds.
    15. Cordero, José Manuel & Alonso-Morán, Edurne & Nuño-Solinis, Roberto & Orueta, Juan F. & Arce, Regina Sauto, 2015. "Efficiency assessment of primary care providers: A conditional nonparametric approach," European Journal of Operational Research, Elsevier, vol. 240(1), pages 235-244.
    16. Victor V. Podinovski & Wan Rohaida Wan Husain, 2017. "The hybrid returns-to-scale model and its extension by production trade-offs: an application to the efficiency assessment of public universities in Malaysia," Annals of Operations Research, Springer, vol. 250(1), pages 65-84, March.
    17. Thanassoulis, Emmanuel & Silva Portela, Maria C.A. & Graveney, Mike, 2012. "Estimating the scope for savings in referrals and drug prescription costs in the general Practice units of a UK primary care trust," European Journal of Operational Research, Elsevier, vol. 221(2), pages 432-444.
    18. Margit Sommersguter-Reichmann, 2022. "Health care quality in nonparametric efficiency studies: a review," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 30(1), pages 67-131, March.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:ijhplm:v:34:y:2019:i:1:p:196-215. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0749-6753 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.