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Publicação
Cuidados de saúde primários em Portugal
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Orientador(es)
Resumo(s)
0 objetivo desta dissertação é avaliar a reforma dos cuidados de saúde primários
iniciada em 2005. E apresentada uma evolução histórica, mostrando-se que esta reforma
procurou solucionar problemas na acessibilidade, qualidade e continuidade dos
cuidados atraves da implementação de urn novo modelo de gestão e remuneração dos
profissionais.
Como a reforma permitiu uma adesao voluntária, coexistem unidades
prestadoras públicas a funcionar sob diferentes modelos. Assim, a análise do impacto da
reforma pode ser realizada comparando a eficiencia dos dois tipos de unidades: as
Unidades de Saude Familiar, que funcionam de acordo com o novo modelo, e as
Unidades de Cuidados de Saude Personalizados, que se mantiveram no anterior modelo.
A análise foi realizada utilizando o método de análise envolvente de dados,
tendo sido utilizados testes não paramétricos que permitiram validar a escolha das
variáveis, garantindo que obedecem aos pressupostos do método.
Esta avaliação, realizada utilizando dados originais de 2011 referentes a região
de Lisboa e Vale do Tejo, permitiu concluir que as Unidades de Saúde Familiar foram
mais eficientes do ponto de vista tecnológico, técnico e económico. Foi também
possivel mostrar que as diferenças se devem ao novo modelo e não às caracteristicas
intrinsecas dos profissionais que a ele aderiram.
The aim of this dissertation is to evaluate the reform of primary health care launched in 2005. An historical perspective is presented, showing that this reform was implemented to overcome problems of accessibility, quality and continuity of care through the implementation of a new management model and remuneration scheme. As the reform allowed voluntary membership, there are public units providing primary health care operating under different models. Thus, the analysis of the impact of the reform can be accomplished by comparing the efficiency of the two types of units: Family Health Units, which operate according to the new model, and Personalized Healthcare Units, which remained on the previous model. The analysis was implemented using data envelopment analysis. Nonparametric tests were used to validate the choice of variables, ensuring that they satisfy the requirements of the method. This evaluation, conducted using original data of 2011 for the region of Lisbon and Tagus Valley, concluded that Family Health Units performed better in terms of technological, technical and economic efficiency. It was also possible to show that differences in efficiency are due to the new management model and remuneration scheme and not to the characteristics of professionals that moved to the new scheme.
The aim of this dissertation is to evaluate the reform of primary health care launched in 2005. An historical perspective is presented, showing that this reform was implemented to overcome problems of accessibility, quality and continuity of care through the implementation of a new management model and remuneration scheme. As the reform allowed voluntary membership, there are public units providing primary health care operating under different models. Thus, the analysis of the impact of the reform can be accomplished by comparing the efficiency of the two types of units: Family Health Units, which operate according to the new model, and Personalized Healthcare Units, which remained on the previous model. The analysis was implemented using data envelopment analysis. Nonparametric tests were used to validate the choice of variables, ensuring that they satisfy the requirements of the method. This evaluation, conducted using original data of 2011 for the region of Lisbon and Tagus Valley, concluded that Family Health Units performed better in terms of technological, technical and economic efficiency. It was also possible to show that differences in efficiency are due to the new management model and remuneration scheme and not to the characteristics of professionals that moved to the new scheme.
Descrição
Doutoramento em Economia
Palavras-chave
Economia da saúde Eficiência Análise envolvente de dados Cuidados de saúde primários Unidades de saúde familiar Portugal Health economics Efficiency Data envelopment analysis Primary health care Family health units
Contexto Educativo
Citação
Miguel, Luís Silva (2013). " Os cuidados de saúde primários em Portugal". Tese de Doutoramento, Universidade Técnica de Lisboa. Instituto Superior de Economia e Gestão.
Editora
Instituto Superior de Economia e Gestão