Health Systems in Transition

Health systems in transition

Portugal

165

The National Plan for Patient Safety 2015–2020 must be adapted by each

health care facility based on particular organizational features. The Plan intends

to improve safe health care provision at all levels of care by encouraging cross-

cutting actions such as enhancing a culture of safety and promoting the sharing

of knowledge and information.

In 2013, the DGH launched the programme for the prevention and control

of antimicrobial resistance and infections, recognizing health care-associated

infections as an important cause of morbidity and mortality that leads to

increased consumption of hospital and community resources. Considering that

Portugal is one of the EU countries with the highest prevalence of nosocomial

infections – the latest DGH estimates for 2013 show that 9.8% of patients were

identified with a nosocomial infection – there had been a lack of action to

reduce rates of health care-associated infections. For a long time, Portugal was

above the EU average regarding antibiotic consumption in ambulatory care,

but that trend was inverted in recent years (DGS, 2016). Since 2012, while the

consumption of antibiotics in Europe has increased, there has been a sharp

reduction in Portugal, ranking the country 16th of 30 European countries in

2014 and below the EU average, regarding antibiotic consumption in ambulatory

care (DGS, 2016).

Data from the OECD database on health care quality and safety show that

Portugal is in a comfortable position in terms of in-hospital mortality rates

(deaths within 30 days of admission), quality of primary care for chronic

conditions and complications following surgical procedures.

In terms of age and sex, the standardized in-hospital mortality rate per

100 patients for acute myocardial infarction in Portugal (10.4) is close to that

for the United Kingdom (9.1) but is lower than Latvia (19.1) and higher than

Italy (7.5) and Spain (8.2) according to 2013 data. A similar scenario is found

for 30-day mortality after admission to hospital for ischaemic stroke and

haemorrhagic stroke.

As for quality of primary care for chronic diseases, among the countries

considered, Portugal is one of those with the lowest age- and sex-standardized

rates per 100 000 population for avoidable admissions due to asthma, chronic

obstructive pulmonary disease and congestive heart failure, which suggests that

these conditions are being effectively managed at the primary health care level

and that the care delivered at this level is of good quality. As for hypertension

and diabetes, although the figures are also good and below those of France and

Latvia, they are higher than for the United Kingdom and Spain, suggesting that

there is space for improvement.