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Health systems in transition
Portugal
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In the MoU signed by Portugal in the context of the Economic and
Financial Adjustment Programme, the Portuguese Government agreed to
“set up a system for comparing hospital performance (benchmarking) on
the basis of a comprehensive set of indicators and produce regular annual
reports” (MoU, 2011). To fulfil this commitment, in 2013 the ACSS published
the first quarterly report highlighting their benchmarking analysis, which
covered both public and P-PPs hospitals (ACSS, 2013). The report aimed to
assess the potential for improvement within each hospital in each major area
of activity and to identify best practices and cross-cutting programmes to
launch in the near future that may lead to improvements across the system.
In 2014 and 2015, new reports for hospitals were launched, and in 2014
primary care centre groups (ACES) were also included in the benchmarking
analysis, to improve monitoring within the NHS (results are available at:
http://benchmarking.acss.min-saude.pt/).
5.4.1 Day care
Day care services are provided by the RNCCI (see section 5.8). Day care includes
those services provided to patients that need specific health care services but
do not need to stay overnight (e.g. haemodialysis, physiotherapy). Day care
services provide integrated support care to promote autonomy and give social
support in an ambulatory regimen, i.e. without resorting to an inpatient acute
care setting, to people with different levels of dependence that are not cared for
at home. It guarantees maintenance and stimulation activities, medical care, and
periodical nursing care, periodical psychiatric control, psychosocial support,
socio-cultural animation, nutrition and personal hygiene, when necessary. Day
care has been strongly developed in the last decade, namely at hospital level.
Besides ambulatory surgery, which currently accounts for an important share
of the overall number of surgeries performed at NHS hospitals, an increasing
number of specialties are providing day care services, including dialysis,
dermatology, psychiatry and clinical haematology.
5.5 Emergency care
The INEM is the Ministry of Health’s organization responsible for the
coordination and functioning of an integrated medical emergency system in
mainland Portugal (Azores and Madeira have their own system). This system
ensures the rapid and appropriate delivery of emergency care. The main tasks of
the INEM include: providing medical aid at the scene; assisting transportation