HHE HOPE 2019 - Page 20

restricted the coverage of some types of treatment, particularly dental care. Veneto Region went through a reform reducing the number of Trusts from 21 to nine. The impact of such reform was important because this resulted in a new distribution of competences. The Zero Trust centralised all the administrative functions such as nursing recruitment, large procurement, regional education and health technology assessment. The centralisation of ICT services offers a new important challenge for storing and managing health and organisational information in a unique digital archive. involvement of professionals holding managerial responsibilities; and increase NHS professionals’ productivity and satisfaction levels, linking the institutional and financial incentives allocation to the performance effectively achieved. 6 Affordable and quality palliative care 7 The Strategy for the Development of Palliative Care resulted in a National Network of Palliative Care, integrated in the NHS and implemented at all levels of healthcare. Digital transformation (E-Health) In 2017, the National Strategy for Health Information Ecosystem 2020 was approved, 8 which aims to increase citizens’ interaction with health technology. To this end, it provides the availability of multiple digital service platforms that allow information access and sharing, but also the simplification and informatisation of registries and processes in the NHS till 2020 such as E-Prescription, Electronic health record, Portal SNS 9 and mobile applications (MySNS, 10 MySNS TEMPOS, 11 MySNS CARTEIRA 12 ). PORTUGAL Mr Carlos Pereira Alves HOPE Governor, Portuguese Association for Hospital Development Clinical Academic Centres and University Hospitals In 2018, Clinical Academic Centres were created and pilot projects of University Hospitals were established. 13 Clinical academic centres are consortiums and associations of healthcare units (for example, hospitals), higher education institutions (for example, universities) and/or research institutions (public or private). These centers are dedicated to the promotion of integrated healthcare, teaching, clinical research and translation. With the pilot projects of university hospitals, some established university hospital centres were reorganised to improve their working processes and functions. Could you describe the last hospital and/ or healthcare reforms implemented in your country in the past 5 years? Primary healthcare reform 4 In recent years, the Primary Healthcare Network has been strengthened and expanded, through the deepening of the Primary Health Unit’s model and performance, with the objective of increasing the NHS response and assigning a family health team to all residents. Integrated responsibility centres In 2018, the model of Integrated Responsibility Centres (CRIs) that are organic intermediate management structures, dependent on the NHS public entities boards of directors was defined. 5 The CRIs have functional autonomy and establish an economic and financial assistance commitment, following the presentation of an action plan that defines the healthcare programme for a period of three years. The CRIs are created to ensure the development of best clinical practices focused on the users’ needs; foster clinical governance processes and therefore care quality improvement; increase the accessibility and timely response of the NHS to citizens; mobilise the installed capacity in the NHS public network; promote the autonomy and Could you present two/three elements on the impact of such reforms on hospital and/ or healthcare sectors that your organisation/ country has identified? The reinforcement and expansion of the Primary Healthcare Network significantly improved primary healthcare, in terms of accessibility and quality. On one hand, this is visible by the increase in the number of Portuguese with family doctor (93 % in 2017); and on the other hand, by the number of medical appointments, which is over 30 million per year. In January 2018, the highest number of physicians, nurses and diagnostic and therapeutic technicians, working in the NHS, in the last ten years was registered. PORTUGAL Total current health expenditure as % of Gross Domestic Product (GDP) General government/compulsory current health expenditure as % of total current health expenditure Hospital current health expenditure, as % of total current health expenditure Household out-of-pocket health expenditure as % of total current health expenditure All hospital beds per 100,000 inhabitants Acute care hospital beds per 100,000 inhabitants Acute care admissions/discharges per 100 inhabitants Average length of stay for acute care hospitals (bed-days) Practising physicians per 100,000 inhabitants Practising nurses per 100,000 inhabitants 20 HHE 2019 | hospitalhealthcare.com 2002 8.6% 72.6% 38.1% 22.6% 357.0 351.0 11.1 7.2 n.a. n.a. 2008 2016 9.4% 9.1% 68.4% 66.4% 38.3% 42.2% 25.8% 27.8% 339.0 342.0 333.0 329.0 11.3 10.8 6.8 7.2 n.a. n.a. n.a. n.a.