Financial crisis in Portugal: effects in the health care sector

Alexandre Morais Nunes, Diogo Cunha Ferreira, Adalberto Campos Fernandes

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Portugal has faced an economic and financial crisis that began circa FY2009 and whose effects are still ongoing. In FY2011, the Portuguese state and the European triumvirate – composed of the European Commission, the International Monetary Fund, and the European Central Bank – signed the Memoranda of Understanding. This troika agreement aimed to improve the operational efficiency of public services. This crisis had a considerable impact on the Portuguese citizens’ life and productivity, as well as on the public health care system. Cuts over public expenditures have been made to reduce the risk of noncompliance with budgetary targets, despite their potential impact on quality and access to health care services. We analyzed the main policies and measures undertaken by the Portuguese Ministry of Health with respect to the bailout program associated with the troika agreement. Then, we focused on the budgetary cuts–related risks over the social performance of the care system. Evidence suggests that structural reforms in the health care sector in the troika period had positive effects in terms of drugs administration and consumption, on the one hand, and secondary care expenditures reduction, on the other hand. Nonetheless, we observed some divestitures on infrastructures and the worsening of access to health care services.

Original languageEnglish
Pages (from-to)237-259
Number of pages23
JournalInternational Journal of Health Services
Issue number2
Publication statusPublished - 1 Apr 2019


  • access
  • efficiency
  • health care
  • National Health Service
  • Portuguese financial crisis

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