The Great Recession in Portugal: impact on hospital care use

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19 Citations (Scopus)

Abstract

The Great Recession started in Portugal in 2009, coupled with severe austerity. This study examines its impact on hospital care utilization, interpreted as caused by demand-side effects (related to variations in population income and health) and supply-side effects (related to hospitals' tighter budgets and reduced capacity).The database included all in-patient stays at all Portuguese NHS hospitals over the 2001-2012 period (n= 17.7 millions). We analyzed changes in discharge rates, casemix index, and length of stay (LOS), using a before-after methodology. We additionally measured the association of health care indicators to unemployment.A 3.2% higher rate of discharges was observed after 2009. Urgent stays increased by 2.5%, while elective in-patient stays decreased by 1.4% after 2011. The LOS was 2.8% shorter after the crisis onset, essentially driven by the 4.5% decrease among non-elective stays. A one percentage point increase in unemployment rate was associated to a 0.4% increase in total volume, a 2.3% decrease in day cases, and a 0.1% decrease in LOS.The increase in total and urgent cases may reflect delayed out-patient care and health deterioration; the reduced volume of elective stays possibly signal a reduced capacity; finally, the shorter stays may indicate either efficiency-enhancing measures or reduced quality.

Original languageEnglish
Pages (from-to)307-315
Number of pages9
JournalHealth Policy
Volume119
Issue number3
DOIs
Publication statusPublished - 1 Mar 2015

Keywords

  • Austerity
  • Healthcare use
  • Portugal
  • Recession

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