How Portugal compares in 2022 (part II): health and healthcare profile
Continuing the analysis of the 2022 Health at Glance report signed by the OECD, draw up a general profile of the health of the Portuguese and health care. We stress the caution in interpretation imposed by the methodological limitations of this report. However, it is possible to get an illustrative idea of how Portugal ranks in the international comparison for the analyzed indicators.
In Portugal, people live longer, but with more disease, especially women. On average, women live healthy up to 72 years (the European average is 75 years), while men 73.5 years (the European average is 74.5 years).
It is, therefore, not surprising that in Portugal there is a high prevalence of chronic diseases, in particular diabetes, but also depression, knowing that funding for disease prevention is not only low but the increase has been at one slower pace than that seen in other countries.
Even so, there is a relevant fact: apart from the interruption that the management of Covid-19 causes in the monitoring of all other diseases (a fact highlighted in the previous text), the main chronic diseases – including diabetes, heart disease, asthma and lung disease chronic obstructive – appears to be under control.
This is demonstrated by the fact that the country compares relatively well on the factors that cause early deaths. What these data seem to show is that the country manages to respond to the most serious and urgent clinical situations, although it has difficulty in managing the comorbidities that will affect the population as it ages.
Attention to the management of chronic and incurable diseases seems to have entered the agenda and proof of this is that public spending on long-term care is already in line with the European average: 7% of GDP.
Speaking of funding, healthcare spending in Portugal is similar to the European average (10.5% of GDP). But there is a big problem: this amount stems from household spending on insurance and direct payments. The weight of this expenditure component is very high for a country with a National Health Service (SNS) and only Greece, Malta or Latvia.
It means that public spending on medication, consultations, surgeries, exams, treatments, prostheses and orthoses is low, which is why families look for financing alternatives that are within their reach.
The consequence of this lack of protection is easy to understand. Socioeconomic differences were felt in health outcomes (for example, overweight is greater among less educated people) and in the dissatisfaction of the population’s health needs (the oral health situation is among the worst in Europe, even despite the effort to increase the offer in health centers).
Finally, the area of human resources is one of the areas that Portugal shows the greatest psychologist. The nurse is not only in the inability to attract, retain and distribute health professionals by services, specialties and regions. This is transversal to most countries, although it should be noted that several solutions are available to be tested to deal with the situation.
Portugal’s concern also stems from the lack of data beyond doctors, nurses and pharmacists and data on working and contractual conditions in the public, private and social sectors. This shortcoming is a clear case of political inaction, given that there is legislation to correct the problem.
The most conclusive information concerns the lack of nurses and remuneration. In the case of physicians, remuneration remains below 2010 values – the cuts negotiated with the Troika were achieved –; and in the case of nurses, the salary in purchasing power parity is far below European values, being only higher than Latvia and Lithuania.