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The effects of austerity measures on quality of healthcare services:

2017-12-12Artigo científico Acesso aberto
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dc.contributor.authorCorreia, Tiago
dc.contributor.authorCarapinheiro, Graça
dc.contributor.authorCarvalho, Helena
dc.contributor.authorSilva, J.M.
dc.contributor.authorDussault, Gilles
dc.contributor.institutionGlobal Health and Tropical Medicine (GHTM)
dc.contributor.institutionInstituto de Higiene e Medicina Tropical (IHMT)
dc.contributor.institutionPopulation health, policies and services (PPS)
dc.contributor.pblWorld Health Organization | BioMed Central (BMC)
dc.date.accessioned2018-05-10T22:21:41Z
dc.date.available2018-05-10T22:21:41Z
dc.date.issued2017-12-12
dc.description.abstractBackground: The European Union member countries reacted differently to the 2008 economic and financial crisis. However, few countries have monitored the outcomes of their policy responses, and there is therefore little evidence as to whether or not savings undermined the performance of health systems. We discuss the situation in Portugal, where a financial adjustment program was implemented between 2011 and 2014, and explore the views of health workers on the effects of austerity measures on quality of care delivery. Methods: A nationwide survey of physicians' experiences was conducted in 2013-2014 (n=3442). We used a two-step model to compare public and private services and look at the possible moderating effects of the physicians' specialty and years of practice. Our data analysis included descriptive statistics, the independent t test, analysis of variance (ANOVA), multivariate logistic regression, General Linear Model Univariate Analysis, non-parametric methods (bootstrap), and post hoc probing. Results: Mainly in the public sector, the policy goal of maintaining quality of care was undermined by a lack of resources, the deterioration in medical residency conditions, and to a lesser extent, greater administrative interference in clinical decision-making. Differences in public and private services showed that the effects of the austerity measures were not the same throughout the health system. Our results also showed that physicians with similar years of practice and in the same medical specialty did not necessarily experience the same pressures. Conclusions: The debate on the effects of austerity measures should focus more closely on health workers' concrete experiences, as they demonstrate the non-linearity between policy setting and expected outcomes. We also suggest that it is necessary to explore the interplay between lower quality and the undermining of trust relationships in health.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent12
dc.format.extent791692
dc.identifier.doi10.1186/s12960-017-0256-6
dc.identifier.issn1478-4491
dc.identifier.otherPURE: 3766516
dc.identifier.otherPURE UUID: 814e19e2-d9e6-4ca2-9c3f-9a1fe0f9102d
dc.identifier.otherScopus: 85037981246
dc.identifier.otherPubMed: 29233172
dc.identifier.otherPubMedCentral: PMC5727927
dc.identifier.urihttp://www.scopus.com/inward/record.url?scp=85037981246&partnerID=8YFLogxK
dc.identifier.urlhttps://www.scopus.com/pages/publications/85037981246
dc.language.isoeng
dc.peerreviewedyes
dc.subjectAdjustment programs
dc.subjectAusterity measures
dc.subjectEconomic crisis
dc.subjectPortugal
dc.subjectQuality of care
dc.subjectTrust
dc.subjectPublic Administration
dc.subjectPublic Health, Environmental and Occupational Health
dc.subjectSDG 3 - Good Health and Well-being
dc.titleThe effects of austerity measures on quality of healthcare services:en
dc.title.subtitlea national survey of physicians in the public and private sectors in Portugalen
dc.typejournal article
degois.publication.issue1
degois.publication.titleHuman resources for health
degois.publication.volume15
dspace.entity.typePublication
rcaap.rightsopenAccess

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