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Health systems in transition
Portugal
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Regarding outpatient consultations, information is made public on the
average time of response to the first outpatient consultation (in days) requested
by primary care units, by specialty and priority level, for each hospital institution
and the number of patients who are waiting for consultation. According to the
Ordinance No. 95/2013, of 4 March 2013, the maximum guaranteed response
time is: High Priority – 30 days; Priority – 60 days; Standard – 150 days.
There is also publicly available information on the average waiting time
for elective surgery (in days), by specialty, priority and pathology, for each
hospital institution, as well as the number of patients who are waiting for
scheduled surgery. The waiting time for elective surgery, the length of time
between the proposal (date of registration) and the day of the respective
surgery are considered. According to Ordinance No. 87/2015 of 15 March
2015, the maximum guaranteed response time, by priority and pathology, is:
High Priority (oncological or non-oncological disease) – 15 days; Priority –
45 days for oncological disease and 60 days for non-oncological disease;
Standard – 60 days for oncological disease and 270 days for non-oncological
disease. However, there are no effective mechanisms to enforce these targets.
The analysis of unmet needs for physical examination shows that 5.5% of
the Portuguese population could not access health care due to financial or other
reasons (Fig. 7.2). When analysing the results by income quintile, 9.4% of those
belonging to the poorest quintile could not access health care for financial or
other reasons but that percentage falls to 2% in the richest quintile (Fig. 7.2).
Regarding dental care, 48.7% of the population aged 15 years or older had a visit
to the dentist in the previous year (INE/INSA, 2016). However, the proportion
of those who visited a dentist in the past year decreased with age: from 64.2% in
the age group 15–24 years to only 21.7% in those aged 75 years or older. Overall,
Portugal is below the EU average but still shows a high level of inequality in
accessing health care, considering the universal and comprehensive NHS.
Concerning economic evaluation and consequent provision of coverage for
pharmaceutical expenses, in Portugal, as in other countries, pharmaceutical
products face an economic hurdle before they are included under NHS coverage.
Each recent pharmaceutical available for sale in pharmacies is subject to an
economic evaluation. No major changes to the NHS coverage are expected.