[go: up one dir, main page]

IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v120y2016i7p833-839.html
   My bibliography  Save this article

Effects of the financial crisis and Troika austerity measures on health and health care access in Portugal

Author

Listed:
  • Legido-Quigley, Helena
  • Karanikolos, Marina
  • Hernandez-Plaza, Sonia
  • de Freitas, Cláudia
  • Bernardo, Luís
  • Padilla, Beatriz
  • Sá Machado, Rita
  • Diaz-Ordaz, Karla
  • Stuckler, David
  • McKee, Martin
Abstract
Although Portugal has been deeply affected by the global financial crisis, the impact of the recession and subsequent austerity on health and to health care has attracted relatively little attention. We used several sources of data including the European Union Statistics for Income and Living Conditions (EU-SILC) which tracks unmet medical need during the recession and before and after the Troika's austerity package. Our results show that the odds of respondents reporting having an unmet medical need more than doubled between 2010 and 2012 (OR=2.41, 95% CI 2.01–2.89), with the greatest impact on those in employment, followed by the unemployed, retired, and other economically inactive groups. The reasons for not seeking care involved a combination of factors, with a 68% higher odds of citing financial barriers (OR=1.68, 95% CI 1.32–2.12), more than twice the odds of citing waiting times and inability to take time off work or family responsibilities (OR 2.18, 95% CI 1.20–3.98), and a large increase of reporting delaying care in the hope that the problem would resolve on its own (OR=13.98, 95% CI 6.51–30.02). Individual-level studies from Portugal also suggest that co-payments at primary and hospital level are having a negative effect on the most vulnerable living in disadvantaged areas, and that health care professionals have concerns about the impact of recession and subsequent austerity measures on the quality of care provided. The Portuguese government no longer needs external assistance, but these findings suggest that measures are now needed to mitigate the damage incurred by the crisis and austerity.

Suggested Citation

  • Legido-Quigley, Helena & Karanikolos, Marina & Hernandez-Plaza, Sonia & de Freitas, Cláudia & Bernardo, Luís & Padilla, Beatriz & Sá Machado, Rita & Diaz-Ordaz, Karla & Stuckler, David & McKee, Martin, 2016. "Effects of the financial crisis and Troika austerity measures on health and health care access in Portugal," Health Policy, Elsevier, vol. 120(7), pages 833-839.
  • Handle: RePEc:eee:hepoli:v:120:y:2016:i:7:p:833-839
    DOI: 10.1016/j.healthpol.2016.04.009
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851016300860
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.healthpol.2016.04.009?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. David Morgan & Roberto Astolfi, 2013. "Health Spending Growth at Zero: Which Countries, Which Sectors Are Most Affected?," OECD Health Working Papers 60, OECD Publishing.
    2. Correia, Tiago & Dussault, Gilles & Pontes, Carla, 2015. "The impact of the financial crisis on human resources for health policies in three southern-Europe countries," Health Policy, Elsevier, vol. 119(12), pages 1600-1605.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Teresa Neves & Pedro Parreira & Vitor Rodrigues & João Graveto, 2022. "Organizational Commitment and Intention to Leave of Nurses in Portuguese Hospitals," IJERPH, MDPI, vol. 19(4), pages 1-14, February.
    2. Gloria Macassa & Cormac McGrath & Mamunur Rashid & Joaquim Soares, 2021. "Structural Violence and Health-Related Outcomes in Europe: A Descriptive Systematic Review," IJERPH, MDPI, vol. 18(13), pages 1-14, June.
    3. Rocco Palumbo, 2017. "Toward a new conceptualization of health care services to inspire public health. Public national health service as a “common pool of resources”," International Review on Public and Nonprofit Marketing, Springer;International Association of Public and Non-Profit Marketing, vol. 14(3), pages 271-287, September.
    4. Tavares, Lara Patrício & Zantomio, Francesca, 2017. "Inequity in healthcare use among older people after 2008: The case of southern European countries," Health Policy, Elsevier, vol. 121(10), pages 1063-1071.
    5. Inês Casquilho-Martins & Soraia Ferreira, 2022. "Migrants’ Health Policies and Access to Health Care in Portugal within the European Framework," Societies, MDPI, vol. 12(2), pages 1-21, March.
    6. Cristina Borra & Jerònia Pons-Pons & Margarita Vilar-Rodríguez, 2020. "Austerity, healthcare provision, and health outcomes in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 409-423, April.
    7. Costa, Diogo & Cunha, Marina & Ferreira, Cláudia & Gama, Augusta & Machado-Rodrigues, Aristides M. & Rosado-Marques, Vítor & Nogueira, Helena & Silva, Maria-Raquel G. & Padez, Cristina, 2020. "Children mental health after the 2008 global economic crisis: Assessing the impact of austerity in Portugal," Children and Youth Services Review, Elsevier, vol. 118(C).
    8. Cláudia Costa & Paula Santana, 2021. "Gender and Age Differences in Socio‐economic Inequalities in Total and Avoidable Mortality in Portugal: A Trend Analysis," Fiscal Studies, John Wiley & Sons, vol. 42(1), pages 123-145, March.
    9. Inácio, Pedro & Gomes, João José & Airaksinen, Marja & Cavaco, Afonso, 2018. "Exploring sociodemographic and economic factors that promote adverse drug reactions reporting by patients," Health Policy, Elsevier, vol. 122(3), pages 263-268.
    10. Ansgar Belke, 2020. "Depression and grief as a result of economic and financial crises: the example of Greece and some generalizations," Economic Change and Restructuring, Springer, vol. 53(1), pages 139-149, February.
    11. Noto, Guido & Belardi, Paolo & Vainieri, Milena, 2020. "Unintended consequences of expenditure targets on resource allocation in health systems," Health Policy, Elsevier, vol. 124(4), pages 462-469.
    12. Regina Queiroz, 2018. "Individual liberty and the importance of the concept of the people," Palgrave Communications, Palgrave Macmillan, vol. 4(1), pages 1-12, December.
    13. Claudia Costa & Angela Freitas & Ricardo Almendra & Paula Santana, 2020. "The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal," IJERPH, MDPI, vol. 17(22), pages 1-16, November.
    14. Antunes, Ana & Frasquilho, Diana & Zózimo, Joana R. & Silva, Manuela & Cardoso, Graça & Ferrão, João & Caldas-de-Almeida, José Miguel, 2019. "Solutions to tackle the mental health consequences of the economic recession: A qualitative study integrating primary health care users and professionals’ perspectives," Health Policy, Elsevier, vol. 123(12), pages 1267-1274.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Masanet, Erika, 2017. "Processes and experiences of Portugal’s international recruitment scheme of Colombian physicians: Did it work?," Health Policy, Elsevier, vol. 121(8), pages 929-935.
    2. Kendy Madero Zambrano & Shirley Fernández Aragón & Moraima Del toro Rubio & Zorayda Barrios Puerta & Yolima Manrique Anay & Sandra L Vallejo Arias, 2018. "The Absurd Consciousness of Those Lying in a Health Care System About to Collapse," Global Journal of Health Science, Canadian Center of Science and Education, vol. 10(12), pages 116-116, December.
    3. Ferreira, Diogo Cunha & Nunes, Alexandre Morais & Marques, Rui Cunha, 2018. "Doctors, nurses, and the optimal scale size in the Portuguese public hospitals," Health Policy, Elsevier, vol. 122(10), pages 1093-1100.
    4. Botezat, Alina & Incaltarau, Cristian & Nijkamp, Peter, 2024. "Nurse migration: Long-run determinants and dynamics of flows in response to health and economic shocks," World Development, Elsevier, vol. 174(C).
    5. Ferreira, Pedro L. & Raposo, Vitor & Tavares, Aida Isabel & Correia, Tiago, 2020. "Drivers for emigration among healthcare professionals: Testing an analytical model in a primary healthcare setting," Health Policy, Elsevier, vol. 124(7), pages 751-757.
    6. Mohammad Heydari & Kin Keung Lai & Yanan Fan & Xiaoyang Li, 2022. "A Review of Emergency and Disaster Management in the Process of Healthcare Operation Management for Improving Hospital Surgical Intake Capacity," Mathematics, MDPI, vol. 10(15), pages 1-34, August.
    7. Alessandro Stievano & Douglas Olsen & Ymelda Tolentino Diaz & Laura Sabatino & Gennaro Rocco, 2017. "Indian nurses in Italy: a qualitative study of their professional and social integration," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(23-24), pages 4234-4245, December.
    8. Correia, Tiago & Gomes, Inês & Nunes, Patrícia & Dussault, Gilles, 2020. "Health workforce monitoring in Portugal: Does it support strategic planning and policy-making?," Health Policy, Elsevier, vol. 124(3), pages 303-310.
    9. Petrou, Panagiotis & Vandoros, Sotiris, 2018. "Healthcare reforms in Cyprus 2013–2017: Does the crisis mark the end of the healthcare sector as we know it?," Health Policy, Elsevier, vol. 122(2), pages 75-80.
    10. Helen M. Lloyd & Inger Ekman & Heather L. Rogers & Vítor Raposo & Paulo Melo & Valentina D. Marinkovic & Sandra C. Buttigieg & Einav Srulovici & Roman Andrzej Lewandowski & Nicky Britten, 2020. "Supporting Innovative Person-Centred Care in Financially Constrained Environments: The WE CARE Exploratory Health Laboratory Evaluation Strategy," IJERPH, MDPI, vol. 17(9), pages 1-19, April.
    11. DOGAN Mihaela Simona & BUZILA Nicoleta & GORDEAN Raoul, 2013. "Health Systems and Their Importance in the Europe 2020 Strategy," Anale. Seria Stiinte Economice. Timisoara, Faculty of Economics, Tibiscus University in Timisoara, vol. 0, pages 209-212, May.
    12. Pavolini, Emmanuele & Kuhlmann, Ellen, 2016. "Health workforce development in the European Union: A matrix for comparing trajectories of change in the professions," Health Policy, Elsevier, vol. 120(6), pages 654-664.
    13. Ramos, Pedro & Alves, Hélio, 2017. "Migration intentions among Portuguese junior doctors: Results from a survey," Health Policy, Elsevier, vol. 121(12), pages 1208-1214.
    14. Cristian Incaltarau & Adrian V. Horodnic & Colin C. Williams & Liviu Oprea, 2021. "Institutional Determinants of Informal Payments for Health Services: An Exploratory Analysis across 117 Countries," IJERPH, MDPI, vol. 18(23), pages 1-19, November.
    15. Aida Ribera & John Slof & Ignacio Ferreira-González & Vicente Serra & Bruno García-del Blanco & Purificació Cascant & Rut Andrea & Carlos Falces & Enrique Gutiérrez & Raquel del Valle-Fernández & Césa, 2018. "The impact of waiting for intervention on costs and effectiveness: the case of transcatheter aortic valve replacement," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(7), pages 945-956, September.
    16. Monica Sane Schepisi & Anteo Di Napoli & Rosario Asciutto & Simona Vecchi & Concetta Mirisola & Alessio Petrelli, 2021. "The 2008 Financial Crisis and Changes in Lifestyle-Related Behaviors in Italy, Greece, Spain, and Portugal: A Systematic Review," IJERPH, MDPI, vol. 18(16), pages 1-35, August.
    17. Cláudia Costa & Paula Santana, 2021. "Gender and Age Differences in Socio‐economic Inequalities in Total and Avoidable Mortality in Portugal: A Trend Analysis," Fiscal Studies, John Wiley & Sons, vol. 42(1), pages 123-145, March.
    18. Wenzl, Martin & Naci, Huseyin & Mossialos, Elias, 2017. "Health policy in times of austerity—A conceptual framework for evaluating effects of policy on efficiency and equity illustrated with examples from Europe since 2008," Health Policy, Elsevier, vol. 121(9), pages 947-954.
    19. Pei-Jian Lin & Yih-Chearng Shiue & Gwo-Hshiung Tzeng & Shan-Lin Huang, 2019. "Developing a Sustainable Long-Term Ageing Health Care System Using the DANP-mV Model: Empirical Case of Taiwan," IJERPH, MDPI, vol. 16(8), pages 1-33, April.
    20. Vicarelli, Giovanna & Pavolini, Emmanuele, 2015. "Health workforce governance in Italy," Health Policy, Elsevier, vol. 119(12), pages 1606-1612.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:120:y:2016:i:7:p:833-839. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.