Posts categorized under Health

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.