HEALTH CARE SYSTEMS AND REFORM

Abstract

Background: The Primary Health Care network should be the main gateway to access to health care in Portugal and a fundamental pillar of the National Health Service. Social, economic, political, cultural as well as epidemiological changes have led to a process of initial reform with great impact in particular on the restructuring of the network, with the creation of new forms of organization, which emphasize the Family Health Units, and recognized by the evaluation of the Troika. It is also true that in recent years, this reform has slowed down the initial pace of USF and UCC implementation, the visibility of change has faded, revealing a disinvestment of healthcare restructuring. Objective - Reflect on the need to relaunch reform of Primary Health Care and identify the potential critical success factors. Methodology - Critical review of the literature. Results and conclusions - Equity in access to health care is not fully assured and organizational efficiency gains are not enough to offset the pressure of demand for health care and related costs. The organizational changes implemented have altered interprofessional and interorganizational cooperation relations, reinforcing the already existing tension between the various stakeholders. New organizational forms such as Care Units in the Community can contribute to the balance of costs and mainly welfare gains for the Portuguese. The re-launch of the reform of the primary health care network is imperative to the extent that it can contribute to network sustainability and significantly increase the quality of health care.