IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v121y2017i2p141-148.html
   My bibliography  Save this article

Competition policy for health care provision in Portugal

Author

Listed:
  • Barros, Pedro Pita

Abstract

We review the role of competition among healthcare providers in Portugal, which has a public National Health Service (NHS) at the core of the health system. There is little competition among healthcare providers within the NHS. Competition among NHS primary care providers is hindered by excess demand (many residents in Portugal do not have a designated family doctor). Competition among NHS hospitals has been traditionally limited to cases of maximum guaranteed waiting time for surgery being exceeded. The Portuguese Competition Authority enforces competition law. It has focused on mergers between private hospitals and abuse of market power (including cartel cases) by private healthcare providers. The Healthcare Regulation Authority produced several reports on particular areas of activity by private healthcare providers. The main conclusion of these reviews was lack of conditions for effective competition, with the exception of dentistry. Within the NHS, the use of tendering procedures was able to create “competition for the market” in particular areas though it was not problem free. Details in the particular design adopted matter a lot.

Suggested Citation

  • Barros, Pedro Pita, 2017. "Competition policy for health care provision in Portugal," Health Policy, Elsevier, vol. 121(2), pages 141-148.
    • Handle: RePEc:eee:hepoli:v:121:y:2017:i:2:p:141-148
    DOI: 10.1016/j.healthpol.2016.12.005
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851016303487
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2016.12.005?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. João Amador & Ana Cristina Soares, 2018. "Competition in the Portuguese economy: insights from a profit elasticity approach," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 45(2), pages 339-365, May.
    2. Mónica Duarte Oliveira & Carlos Gouveia Pinto, 2005. "Health care reform in Portugal: an evaluation of the NHS experience," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 203-220, September.
    3. Pedro Pita Barros & Werner B. F. Brouwer & Sarah Thomson & Marco Varkevisser, 2016. "Competition among health care providers: helpful or harmful?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(3), pages 229-233, April.
    4. Helena, Ricardo, 2016. "Cross-border healthcare directive: Assessing stakeholders’ perspectives in Poland and Portugal," Health Policy, Elsevier, vol. 120(4), pages 369-376.
    5. Ricardo Gonçalves & Pedro Pita Barros, 2013. "Economies of scale and scope in the provision of diagnostic techniques and therapeutic services in Portuguese hospitals," Applied Economics, Taylor & Francis Journals, vol. 45(4), pages 415-433, February.
    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. Rita Bastião & Nuno de Sousa Pereira, 2020. "Performance in the Delivery of Primary Health Care Services: A Longitudinal Analysis," CEF.UP Working Papers 2002, Universidade do Porto, Faculdade de Economia do Porto.
    2. Simões, J. & Augusto, G.F. & Fronteira, I., 2017. "Introduction of freedom of choice for hospital outpatient care in Portugal: Implications and results of the 2016 reform," Health Policy, Elsevier, vol. 121(12), pages 1203-1207.
    3. Lu, Liyong & Pan, Jay, 2019. "The association of hospital competition with inpatient costs of stroke: Evidence from China," Social Science & Medicine, Elsevier, vol. 230(C), pages 234-245.
    4. Pereira, Miguel Alves & Figueira, José Rui & Marques, Rui Cunha, 2020. "Using a Choquet integral-based approach for incorporating decision-maker’s preference judgments in a Data Envelopment Analysis model," European Journal of Operational Research, Elsevier, vol. 284(3), pages 1016-1030.
    5. Siciliani, Luigi & Chalkley, Martin & Gravelle, Hugh, 2017. "Policies towards hospital and GP competition in five European countries," Health Policy, Elsevier, vol. 121(2), pages 103-110.
    6. Ferreira, D.C. & Marques, R.C., 2021. "Public-private partnerships in health care services: Do they outperform public hospitals regarding quality and access? Evidence from Portugal," Socio-Economic Planning Sciences, Elsevier, vol. 73(C).
    7. Pereira, Miguel Alves & Marques, Rui Cunha, 2022. "Is sunshine regulation the new prescription to brighten up public hospitals in Portugal?," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    8. Liyong Lu & Jay Pan, 2021. "Does hospital competition lead to medical equipment expansion? Evidence on the medical arms race," Health Care Management Science, Springer, vol. 24(3), pages 582-596, September.

    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. Diesenreiter, Carina & Österle, August, 2021. "Patients as EU citizens? The implementation and corporatist stakeholders’ perceptions of the EU cross-border health care directive in Austria," Health Policy, Elsevier, vol. 125(11), pages 1498-1505.
    2. Charlotte Davies, 2020. "The supply side to procurement in a health market: competition and innovation in hip implants," Working Paper series, University of East Anglia, Centre for Competition Policy (CCP) 2020-01, Centre for Competition Policy, University of East Anglia, Norwich, UK..
    3. Davies, Charlotte & Davies, Stephen, 2021. "Assessing competition in the hip implant industry in the light of recent policy guidance," Social Science & Medicine, Elsevier, vol. 287(C).
    4. Sveréus, Sofia & Kjellsson, Gustav & Rehnberg, Clas, 2018. "Socioeconomic distribution of GP visits following patient choice reform and differences in reimbursement models: Evidence from Sweden," Health Policy, Elsevier, vol. 122(9), pages 949-956.
    5. Ana Cristina Soares & João Amador, 2012. "Measuring competition in the Portuguese economy using profit elasticities," Economic Bulletin and Financial Stability Report Articles and Banco de Portugal Economic Studies, Banco de Portugal, Economics and Research Department.
    6. Roberta Longo & Marisa Miraldo & Andrew Street, 2008. "Price regulation of pluralistic markets subject to provider collusion," Working Papers 045cherp, Centre for Health Economics, University of York.
    7. Ana Cristina Soares & João Amador, 2013. "Competition in the portuguese economy: Estimated price-cost margins under imperfect labour markets," Working Papers w201308, Banco de Portugal, Economics and Research Department.
    8. De Bonis, Riccardo & Marinelli, Giuseppe & Vercelli, Francesco, 2018. "Playing yo-yo with bank competition: New evidence from 1890 to 2014," Explorations in Economic History, Elsevier, vol. 67(C), pages 134-151.
    9. Vengberg, Sofie & Fredriksson, Mio & Winblad, Ulrika, 2019. "Patient choice and provider competition – Quality enhancing drivers in primary care?," Social Science & Medicine, Elsevier, vol. 226(C), pages 217-224.
    10. Visa Pitkänen & Signe Jauhiainen & Ismo Linnosmaa, 2020. "Low risk, high reward? Repeated competitive biddings with multiple winners in health care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 483-500, June.
    11. Helda Azevedo & Céu Mateus, 2014. "Cost effects of hospital mergers in Portugal," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(9), pages 999-1010, December.
    12. Martin Lábaj & Peter Silanič & Christoph Weiss & Biliana Yontcheva, 2018. "Market structure and competition in the healthcare industry," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(8), pages 1087-1110, November.
    13. Sebastian McRae & Jens O. Brunner & Jonathan F. Bard, 2020. "Analyzing economies of scale and scope in hospitals by use of case mix planning," Health Care Management Science, Springer, vol. 23(1), pages 80-101, March.
    14. Oliveira, Monica D. & Bevan, Gwyn, 2008. "Modelling hospital costs to produce evidence for policies that promote equity and efficiency," European Journal of Operational Research, Elsevier, vol. 185(3), pages 933-947, March.
    15. Galina Besstremyannaya, 2015. "Heterogeneous effect of residency matching and prospective payment on labor returns and hospital scale economies," Discussion Papers 15-001, Stanford Institute for Economic Policy Research.
    16. Pedro Pita Barros, 2022. "Quality decreases from introducing patient choice in a National Health Service," Portuguese Economic Journal, Springer;Instituto Superior de Economia e Gestao, vol. 21(3), pages 351-381, September.
    17. Perna, Roberta & Cruz-Martínez, Gibrán & Moreno Fuentes, Francisco Javier, 2022. "Patient mobility within national borders. Drivers and politics of cross-border healthcare agreements in the Spanish decentralized system," Health Policy, Elsevier, vol. 126(11), pages 1187-1193.
    18. Koski, Heli, 2013. "The Impact of the USO on the Profitability of Postal Service Provision in Finland," ETLA Working Papers 22, The Research Institute of the Finnish Economy.
    19. de Vries, Hein & Vahl, Jos & Muris, Jean & Evers, Silvia & van der Horst, Henriëtte & Cheung, Kei Long, 2021. "Effects of the reform of the Dutch healthcare into managed competition: Results of a Delphi study among experts," Health Policy, Elsevier, vol. 125(1), pages 27-33.
    20. Peter Zweifel, 2017. "Competition in the healthcare sector: a missing dimension," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(2), pages 135-138, March.

    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:121:y:2017:i:2:p:141-148. 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.