0140/2024 - A brief approach to contractualization with primary healthcare in the Lisbon and Tagus Valley Regional Health Administration
A contratualização com os cuidados de saúde primários na Administração Regional de Saúde de Lisboa e Vale do Tejo, até 2023
Author:
• Baltazar Ricardo Monteiro - Monteiro, B. R. - <ricardo.monteiro.baltazar@gmail.com>ORCID: https://orcid.org/0000-0002-4876-9439
Co-author(s):
• Luís Augusto Coelho Pisco - Pisco, L. A. C. - <luispisco@mail.telepac.pt>ORCID: https://orcid.org/0000-0002-9007-8949
Abstract:
The article discusses contractualization in Primary Health Care, relating what has been contracted and what has been achieved. The aim was to answer the following question: can contractualization contribute to guaranteeing equity and adequate access to prima-ry healthcare? A case study methodology was used. We used data available on the SNS Portal - transparency and data used in external contractualization.Data collection took place in December 2023. In the Lisbon and Tagus Valley Health Region, there were 29.6 per cent of people registered without a family doctor in 2023. One-year consultation utilization rates between 2021 and 2023 fell progressively (-2.7%). As for cancer screening, in the case of colon and rectum screening, only 34.4% of those contracted were carried out in 2021 and 28.9% in 2022. In terms of the Over-all Performance Index, it was found that the variation intervals between the negotiated proposals and those obtained were above 20 points. Pharmacotherapeutic prescription in Diabetes Mellitus was analyzed, no ACES achieved the expected values.
It was concluded that contractualization has not helped to improve access and equity, as a discrepancy between the situational, or local, strategic planning phases seems to be evident.