Healthcare in Portugal

Healthcare In Portugal

According to the 2010 Human Development Report, the average life expectancy in Portugal was 79.1 years. The Portuguese Health Care System was ranked number 12 in overall performance by the World Health Organization in a 2000 report ranking the health care systems of each of the 190 United Nations member nations. Nonetheless it ranked number 27 as the most expensive per capita Health Care System.

The Portuguese health system is characterized by three coexisting systems: the National Health Service (NHS), special social health insurance schemes for certain professions (health subsystems) and voluntary private health insurance. The NHS provides universal coverage although they have recently been implemented measures to ensure the sustainability of the service, for example, the implementation of user fees that are paid at the end of the treatments.

In addition, about 25% of the population is covered by the health subsystems, 10% by private insurance schemes and another 7% by mutual funds.

The Ministry of Health is responsible for developing health policy as well as managing the NHS. Five regional health administrations are in charge of implementing the national health policy objectives, developing guidelines and protocols and supervising health care delivery. Decentralization efforts have aimed at shifting financial and management responsibility to the regional level. In practice, however, the autonomy of regional health administrations over budget setting and spending has been limited to primary care.

The NHS is predominantly funded through general taxation. Employer (including the state) and employee contributions represent the main funding sources of the health subsystems. In addition, direct payments by the patient and voluntary health insurance premiums account for a large proportion of funding. Similar to the other Eur-A countries, most Portuguese die from noncommunicable diseases. Mortality from cardiovascular diseases (CVD) is higher than in the Eurozone, but its two main components, ischaemic heart disease and cerebrovascular disease, display inverse trends compared with the Eur-A, with cerebrovascular disease being the single biggest killer in Portugal (17%). Portuguese people die 12% less often from cancer than in the Eur-A, but mortality is not declining as rapidly as in the Eur-A. Cancer is more frequent among children as well as among women younger than 44 years. Although lung cancer (slowly increasing among women) and breast cancer (decreasing rapidly) are scarcer, cancer of the cervix and the prostate are more frequent. Portugal has the highest mortality rate for diabetes in the Eur-A, with a sharp increase since the late 1980s.

Portugal’s infant mortality rate has dropped sharply since the 1980s, when 24 of 1000 newborns died in the first year of life. It is now around 3 deaths per a 1000 newborns. This improvement was mainly due to the decrease in neonatal mortality, from 15.5 to 3.4 per 1000 live births.

People are usually well informed about their health status, the positive and negative effects of their behaviour on their health and their use of health care services. Yet their perceptions of their health can differ from what administrative and examination-based data show about levels of illness within populations. Thus, survey results based on self-reporting at the household level complement other data on health status and the use of services. Only one third of adults rated their health as good or very good in Portugal (Kasmel et al., 2004). This is the lowest of the Eur-A countries reporting and reflects the relatively adverse situation of the country in terms of mortality and selected morbidity.