Portugal: health system review

ABSTRACT

This publication reviews recent developments in organization and governance of health system, health financing, health care provision, health reforms and health system performance in Portugal. Overall health indicators such as life expectancy have shown a notable improvement over the last decades. However, improvements in child poverty and its consequences, mental health and quality of life after 65 have been slower and health inequalities remain a problem. All residents in Portugal have access to health care provided by the National Health Service, financed mainly through taxation. Out-of-pocket payments have been increasing over time and the level of cost-sharing is highest for pharmaceutical products. Health care delivery is by both public and private providers. Public provision is predominant in primary care and hospital care, with a gatekeeping system in place for access to hospital care. Pharmaceutical products, diagnostic technologies and private practice by physicians constitute the bulk of private health care provision. In May 2011, the economic crisis led Portugal to sign a Memorandum of Understanding with the International Monetary Fund, the European Commission and the European Central Bank, in exchange for a loan of 78 billion euros. The agreed Economic and Financial Adjustment Programme included 34 measures aimed at increasing cost-containment, improving efficiency and increasing regulation in the health sector. Reforms implemented since 2011 by the Ministry of Health include improving regulation and governance, health promotion, rebalancing the pharmaceutical market, expanding and coordinating long-term and palliative care, and strengthening primary and hospital care.