Monteiro Baltazar Ricardo, Pisco Ana Maria Silva Azenha, Candoso Fátima, Bastos Sónia, Reis Magda
Gabinete de Auditoria Interna, Administração Regional de Saúde de Lisboa e Vale do Tejo. Av. Estados Unidos da América 77. 1749-096 Lisboa Portugal.
Diretora Executiva do ACeS Oeste Norte, Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa Portugal.
Cien Saude Colet. 2017 Mar;22(3):725-736. doi: 10.1590/1413-81232017223.33462016.
Contractualization consists in the development and implementation of a documented agreement whereby one party (payer) provides compensation to the other party (provider) in exchange for a set of health services to a targeted population. We describe, through a case study, the history and the process of implementation of primary health care contractualization (since 1992) in Portugal, emphasizing the consolidation and future challenges of the primary healthcare reform started in 2005. This article resorts to a case study to reflect on the results obtained in the Cluster of Health Centers of the Northern West, Regional Administration of Lisbon and Tagus Valley, between 2009 and 2015, following implementation of contractualization. It was found that the incentive-related payments will have to be weighted considering the results obtained, strongly influenced by epidemiological and socioeconomic change.
