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Evaluating Portuguese Public Hospitals Performance: Any Difference before and during COVID-19?

Author

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  • Alexandre Morais Nunes

    (Centre for Public Administration and Public Policies, Institute of Social and Political Sciences, Universidade de Lisboa, Rua Almerindo Lessa, 1300-663 Lisbon, Portugal)

  • Diogo Filipe da Cunha Ferreira

    (Centre for Public Administration and Public Policies, Institute of Social and Political Sciences, Universidade de Lisboa, Rua Almerindo Lessa, 1300-663 Lisbon, Portugal
    CERIS, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais 1, 1049-001 Lisbon, Portugal)

Abstract

COVID-19 is a well-known respiratory disease that has spread worldwide since January 2020, causing many deaths and massive pressure on health systems. This pandemic’s appearance compromised health service sustainability and quality as many procedures were postponed or canceled, with an expected increase of adverse events like nosocomial infections, in-hospital deaths, and the worsening of the patient’s clinical status. For instance, the year 2020 featured an increase in undesirable results in Portugal: a rise of 10% in delayed first medical appointments, 0.02% in avoidable bloodstream infections, and more than 100 post-operative pulmonary embolisms and septicemia cases per 100,000 inpatients. Therefore, assessing whether the healthcare providers’ performance has changed is paramount. In this case, we evaluated public hospitals in Portugal. To this end, we developed a network data envelopment analysis model relating to efficiency and effectiveness. We observed consistent drops in efficiency when the pandemic started, followed by a recovery to levels above the pre-pandemic ones. Regarding effectiveness, we observed a positive trend during the evaluated period. We conclude that, apart from the great resilience of public healthcare providers, the Portuguese state was unprepared for a pandemic like COVID-19, but still the actions taken (including massive vaccination) were beneficial.

Suggested Citation

  • Alexandre Morais Nunes & Diogo Filipe da Cunha Ferreira, 2022. "Evaluating Portuguese Public Hospitals Performance: Any Difference before and during COVID-19?," Sustainability, MDPI, vol. 15(1), pages 1-23, December.
  • Handle: RePEc:gam:jsusta:v:15:y:2022:i:1:p:294-:d:1013908
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    References listed on IDEAS

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    1. Guilherme C. Amado & Diogo C. Ferreira & Alexandre M. Nunes, 2022. "Vertical integration in healthcare: What does literature say about improvements on quality, access, efficiency, and costs containment?," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(3), pages 1252-1298, May.
    2. Annika Herr, 2008. "Cost and technical efficiency of German hospitals: does ownership matter?," Health Economics, John Wiley & Sons, Ltd., vol. 17(9), pages 1057-1071, September.
    3. Graziano Abrate & Federico Boffa & Fabrizio Erbetta & Davide Vannoni, 2018. "Voters’ Information, Corruption, and the Efficiency of Local Public Services," Sustainability, MDPI, vol. 10(12), pages 1-22, December.
    4. Pedro Miguel Alves Ribeiro Correia & Ireneu de Oliveira Mendes & Sandra Patrícia Marques Pereira & Inês Subtil, 2020. "The Combat against COVID-19 in Portugal: How State Measures and Data Availability Reinforce Some Organizational Values and Contribute to the Sustainability of the National Health System," Sustainability, MDPI, vol. 12(18), pages 1-13, September.
    5. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October.
    6. Guilhermina Rego & Rui Nunes & José Costa, 2010. "The challenge of corporatisation: the experience of Portuguese public hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(4), pages 367-381, August.
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