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Health systems in transition
Portugal
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Patients who are covered by the health subsystems can go directly to the
private hospitals and specialists approved by their schemes. Private physicians
can also refer them to NHS hospitals. Those patients covered by VHI may be
eligible for private specialist consultations but this will depend on the benefits
package offered.
Box 5.2
A typical pathway after a stroke in Portugal
In Portugal, someone experiencing severe stroke symptoms would take the following steps:
• Call 112 (Medical Emergency hot line) for assistance.
• A specialized first-aid team from INEM is sent to help the patient.
• The patient is taken to the Emergency Service of the referral hospital (according to the place
where the event happened) by an equipped medical ambulance.
• The “Stroke priority lane” (“
Via Verde AVC
”) (a protocol within the ambulance for this type of
patients) is activated while in the ambulance (the hospital is contacted and the information is
provided before the patient’s arrival) and the Emergency Service gets ready to receive the patient.
• The patient is assisted at the Emergency Service: referral to a more specialized hospital, where
ICU or Vascular Surgery are available, takes place if needed.
• During hospitalization, an assessment of the patient’s social and forthcoming needs is made
and the patient’s future after discharge starts to be defined.
• At discharge, a follow-up hospital consultation is scheduled, and the patient is also referred to:
– Community: the patient’s GP receives a discharge summary from the hospital and a
consultation at primary care setting (FHU or PHCU) is scheduled for further assessment,
where provision of long-term care can be considered and arranged (e.g. home visits,
rehabilitation, social support).
– Other institution: depending on the severity of the patient’s condition, referral to the National
Network of Long-term Care can be set in order to improve the patient’s condition until
referral to the GP.