Viewing 12 posts categorized under Health

Well-being patterns during the COVID-19 pandemic

January 25, 2024

This study investigates how the COVID-19 pandemic has affected multi-dimensional capability well-being in seven European countries, with a special emphasis on Portugal. The question at hand is how the pandemic and associated containment measures have impacted people’s capability to lead fulfilling lives, a crucial aspect of overall health and well-being. The study spans from April 2020 to January 2022, utilizing a cross-sectional population survey with nine waves of data. The main focus is on changes in well-being across different countries and demographic subgroups.

Portuguese physician's job preferences

January 22, 2024

The global shortage of doctors has raised concerns about their retention, particularly in the face of tight healthcare budgets. This paper studies the preferences of physicians in order to assess how best to retain them. The paper uses a Discrete Choice Experiment in which 697 physicians in Portugal revealed their preferences by making a sequence of choices between two jobs, based on the job attributes at different levels (see figure).

Do subsidized nursing homes and home care teams reduce hospital bed-blocking?

September 24, 2022

According to the World Health Organization, excessive length of hospital stay is one of the leading sources of inefficiency in healthcare. One possible cause of excessive length of hospital stay is the lack of alternative care arrangements following a hospitalization. When a patient is medically fit to be discharged and yet requires some form of support outside the hospital (a short stay at a nursing home facility or home help), which is not readily available, the patient cannot be safely discharged.

Cancer patients' survival following the reference centre model implementation

July 18, 2022

This paper performs a survival analysis of cancer patients in Portugal, assessing the impact of the creation of oncology Reference Centres (RCs). RCs are a highly specialized healthcare delivery centre, focused on addressing specific health conditions, such as cancer, and delivering best-in-class treatment. Oncology RCs have been officially recognized in Portugal since 2016, following the European Directive 2011/24/EU, and were a National Health System objective during the Economic Stabilization Program. In a context of financial resources scarcity, information about the efficacy of the investments made in RCs is crucial for decision-making concerning funds allocation.

Is there excessive use of emergency care by walk-in patients?

May 19, 2022

The inappropriate use of Emergency Department (ED) service by patients with non-urgent health problems is a worldwide problem, including in Portugal. Nowadays, with the COVID-19 pandemic, the problem is growing and the subject is again on the agenda. Every patient admitted to the ED is submitted to a risk stratification (RS) assessment. Among the various recognized RS systems, the Manchester Triage System (MTS) has international dissemination. MTS establishes five categories/clinical priorities, instituting a colour for each of them.

Who waits for surgeries in Portugal?

April 4, 2022

Wait lists and wait times for scheduled surgery are common in National Health Services-type systems. The analysis of factors that impact wait times for access to surgery has been consistently focused on patients who underwent surgery, ignoring patients that had been on the wait list but did not benefit from surgery due to cancellation by the hospital. This paper studies the effect that cancellation episodes have on understanding wait times.

Self-employment and health outcomes

October 8, 2021

Is self-employment typically good for one’s health? This is an important question as a large number of people around the world and also in Europe are self-employed and many express concerns about the potential negative effects of this type of work. This research question also matters in the context of the Covid crisis. The COVID-19 pandemic may contribute to the growth of self-employment (as the labour market contracts and many individuals look to developed their own work opportunities).

Public-private partnerships in health care services

May 25, 2021

This research compares Portuguese hospital public-private partnerships (PPP) with the corporatized hospitals (EPE) regarding their social performance, between 2012 and 2017. The research accompanies a line of inquiry on whether hospital PPPs are more or less efficient than the traditional model of managing hospitals by focusing on the social side of health care. There is a generalized idea in the public that this type of partnership translates into ruinous contracts for the public purse and poorer health care services.

Competition in the over-the-counter drug market after deregulation: evidence from Portugal

August 3, 2020

In 2005, Portugal allowed over-the-counter (OTC) drugs to be sold outside pharmacies, namely in supermarkets and outlets (parafarmácias). The rationale for OTC market liberalization was simple: the entry of new retailers, combined with free pricing, would lower OTC prices via increased competition. This paper examines whether the entry of new, non-pharmacy OTC retailers triggered price reductions by incumbent pharmacies. The analysis uses data on the prices of five popular OTC drugs at all retailers located in Lisbon, for periods after OTC market liberalization.

Doctors’ response to queues: evidence from a Portuguese emergency department

April 5, 2020

This study analyzes how emergency room doctors change their behavior when the waiting room is crowded. Resources in a fast-care setting such as emergency departments are limited (namely physicians’ time), and so it is important to study the extent to which those restrictions reflect on lower provision of care when more patients are waiting. The paper evaluates doctors’ response to an increase in the number of people waiting on three different dimensions: time spent with patients, number of exams and lab tests during the patient’s visit, and likelihood of being sent home or to a primary care facility rather than being treated at the hospital.

Aging and the compression of disability

December 15, 2019

The age composition of the population in higher income countries has changed considerably. Signs of population aging have prompted concerns about its effects on the cost of health care systems. As people are living longer are they living healthier? On the one hand, the hypothesis of life extension, proposes that we are living longer but in poorer health. On the other hand, the optimistic hypothesis of “morbidity compression” proposes that as we live longer we spent less time in poor health.

Drug decriminalization and the price of illicit drugs

January 10, 2018

_One moderate alternative to the war on drugs is to follow Portugal’s lead and decriminalize all drug use while maintaining the illegality of drug trafficking. – _Gary S. Becker and Kevin M. Murphy (2013) In the late 1980s and 1990s a growing population of intravenous heroin users became a major threat to public health in Portugal, where rates of heroin users were among the highest in Europe. In the mid’90s Portugal engaged in an intensive debate on alternative enforcement policies to deal with drug use and, in 1998, a panel of leading scholars and medical professionals presented a report with recommendations rooted in understanding drug dependency as a disease rather than a crime.