Healthcare in Portugal: Highlights in Hospital Management

Healthcare in Portugal:
Highlights in Hospital Management
Alexandre Lourenço

2
Alexandre Lourenço
Portuguese
President | Portuguese Association of Hospital
Managers (APAH); Board member | European
Health Management Association (EHMA) &
European Association of Hospital Managers
(EAHM)
Hospital administrator | Coimbra Hospital &
University Centre (1.848 acute beds, > 7500
employees)
Nova School of Business and Economics,
Lisboa
World Health Organization Consultant (2014-)
https://www.linkedin.com/in/alexlourenco/

alexandre.lourenco@icloud.com
My talk today
Portuguese health system
Health system challenges
Trends and initiatives

Health status
Some health indicators
PORTO
VISEU
GUARDA
COIMBRA
CASTELO BRANCO
LEIRIA
SANTARÉM
PORTALEGRE
ÉVORA
VIANA DO
CASTELO
BRAGA
VILA REAL
BRAGANÇA
PORTO
AVEIRO
BEJA
SETÚBAL
LISBOA
FARO
AÇORES
PONTA DELGADA
MADEIRA
FUNCHAL

Health status
Infant mortality, 2017 (or nearest year)

Health status
Mortality rates from avoidable causes, 2017
(or nearest year)

Health expenditure
Health expenditure per capita, 2018 (or nearest
year)

Health expenditure
Annual growth in health expenditure per capita (real
terms), 2008 to 2018 (or nearest year)

Provision of care
Hospital beds, 2000 and 2017 (or nearest year)

Provision of care
Avoidable admissions
OECD, 2018

Breast cancer five-year net survival by
stage of breast cancer at diagnosis, 2010-14

Ageing and multimorbidity
Burden of Chronic Disease in Portugal, 2016

Ageing and social exclusion
5% of bed blockers, ALOS nearly 100 days
https://apah.pt/portfolio/barometro-de-internamentos-sociais/

new medicines and medical devices
Spinal muscular atrophy (SMA)

expectations

eHealth & AI
01
Procurement
02
Financing & VBHC
03
Care redesign
04
Innovation &
Economic growth
05

eHealth & IA adoption
barometer
54% hospitals | telemedicine appointments
25% hospitals | remote monitoring
47% hospitals | IA initiatives
https://apah.pt/portfolio/barometro-telessaude-inteligencia-artificial/

IT developments
EHR Primary care & Hospitals integration Universal & mandatory e-prescription

Hospitals benchmarking & transparency
http://monitorizacao.acss.min-saude.pt

Procurement trends
https://www.spms.min-saude.pt
Capital expenditures (CAPEX) to operating
expenses (OPEX)
Centralised procurement

Access to medicines index
44% hospitais reported medicines
shortages on a daily basis
Mostly on generic drugs, where
industry is not delivering (e.g. not
interested in the market due to
low prices, parallel exportation)
https://apah.pt/noticia/resultados-do-index-nacional-do-acesso-ao-medicamento-hospitalar/

eHealth & AI
01
Procurement
02
Financing &
VBHC
03
Care redesign
04
Innovation &
Economic growth
05

New payment models
:https://dx.doi.org/10.1787/9789264258211-en

3f - Financing, formula for the
future
https://www.saudeumaprioridade.pt
Engaged all the stakeholders
10 recommendations
90 measures
2 projects
Parliament endorsement

Farol project on VBHC
Lung cancer - Porto Oncology Institute
https://apah.pt/portfolio/improving-value-in-cancer-care/

Continue increased on one-day-
surgery
http://monitorizacao.acss.min-saude.pt
One day surgery over 65% of all surgeries
One day surgery over 85%
of potential ambulatory surgeries

Polaris integrated care project on ER
hyper-users
4,5% of hyper-users
Responsible for 35% all ER visits
5,72 visits per hyper user (máx. 42)
https://www.saudeumaprioridade.pt

Reconfiguration of acute care
Total life cycle care hospital
Person centred care
development of patient pathways & integrated clinics

Community and patient centred
hospital
New clinical pathways

eHealth & AI
01
Procurement
02
Financing & VBHC
03
Care redesign
04
Innovation &
Economic
growth
05

Strategic agenda for precision
medicine | two projects
Project 1 | Data-driven insights
Clinical & genomic data integration
Clinical decision support algorithm
Project 2 | Cell therapy
Support to the adoption of cell therapy

Healthcare Excellence Award
Best Hospital Administration Practices
The 2019 award was attributed to a remote
ares homecare initiative

INNHospital
New concept of hospitals based on innovation and
technology transfer
AIM: Potentiate research, technological development and innovation
on hospital level,
HOW: Define a new social role for Hospitals, in which they stop being
just resource consumers, and start to actively contribute to society
as producers. This economic revenue comes from de use of scientific
and care knowledge, through the development of innovative
products and services.
600.000€
https://apah.pt/noticia/innhospital/

promotion of innovation

Our cooperative response…
reshaping the ecosystem
Coimbra is a 4 stars Reference
Site according to the
European Innovation Partnership
on Active and Healthy Ageing

OBRIGADO
T +351 915 780 796
WWW.APAH.PT
ALEXANDRE.LOURENCO@APAH.PT

Healthcare in Portugal: Highlights in Hospital Management

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