Nunes Alexandre Morais, Ferreira Diogo Cunha
CESUR, CERis, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
CAPP, Instituto Superior de Ciências Sociais e Políticas, Universidade de Lisboa, Lisbon, Portugal.
Int J Health Plann Manage. 2019 Jan;34(1):196-215. doi: 10.1002/hpm.2613. Epub 2018 Aug 15.
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.
葡萄牙卫生系统的大部分活动集中在1979年创建的国家卫生服务体系，该体系旨在促进全民普遍就医。国家卫生服务体系应确保所提供的所有医疗服务的公平性、效率和质量。本研究评估了2002年至2017年期间医疗政策的影响，重点关注三个时间段：新公共管理原则在医疗领域的采用和适应阶段（2002年至2010年）、经济和金融危机时期（2011 - 2015年）以及危机后恢复期（2016 - 2017年）。本研究评估了卫生部门的主要政策措施，呈现了这些措施在这三个经济时期对就医机会、效率、问责制和成本方面的影响。结果证实，历届政府实施的并非所有措施都取得了预期效果，甚至导致成本增加，不过在紧缩时期，由于财政限制，卫生支出显著减少。
