| Titre | Sixty years of reform in the Portuguese health system: what is the situation with regard to decentralisation? Viewpoint | |
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| Auteur | Ferrinho Paulo, Conceição Cláudia, Biscaia André Rosa, Fronteira Inês, Antunes Ana Rita | |
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Revue | Revue française des Affaires sociales |
| Numéro | no 6, 2006 Reforms and regulation of health care systems in Europe | |
| Rubrique / Thématique | Reforms implemented in several European countries |
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| Page | 297-312 | |
| Résumé anglais |
The authors review 60 years of health care reform in Portugal. The major reforms emerged after the 1974 revolution. The initial period, up to the 1ate 1980s, was a period of development of a very centralised national health service. From the 1990s on wards, concerns with decentralisation were reflected in a number of initiatives: the emergence of regional health authorities; internal health markets and contracting agencies; the purchaser-provider split; entrepreneurial management experiences; local services; vertical (local) integration; and regionalised networks of facilities. These efforts have ensured that health policy, including fiscal matters, remains centrally controlled, while service delivery has increasingly undergone decentralisation, mostly of two types: devolution and deconcentration. Privatisation has also experimented with but has led to recentralisation. Therefore, in Portugal, the search for a decentralised model has involved an ongoing re-balancing of national and sub-national decisionmaking roles. It is not expected that Portugal will see a major decentralisation drive in the near future. Source : Éditeur (via Cairn.info) |
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| Article en ligne | http://www.cairn.info/article.php?ID_ARTICLE=RFAS_EN606_0297 |
