Chapter European Health System Typologies: Last 30 Years Under Review

The quest of the researcher to classify national health systems into homogeneous groups has a long history. In this paper, the last 30 years are divided in two periods (1985–2000 and 2000–2015) in order to present and briefly describe the most influential national health system typologies

Ex-ante Moral Hazard and Primary Prevention, evidence from Portugal

This paper provides evidence on ex-ante moral hazard in Portugal. The issue is addressed in a setting where people buy voluntary private health insurance, on top of existing Government coverage. We identify the main factors that lead people to adopt healthy lifestyles, such as taking up sports and not smoking, which are associated with primary prevention. Moreover, it allows for an inference of the role of risk aversion of individuals in these decisions. We use a GHK recursive simulator of multivariate probit for insurance demand, smoking and sporting decisions, to provide joint estimates taking into consideration potential endogeneity of these decisions. Our results indicate that there is some evidence of ex-ante moral hazard with respect to primary prevention behaviors. Di¤erences in risk aversion across individuals do not seem to play a primary role in explaining distinct life styles.ex-ante moral hazard, prevention, lifestyles

Treatable mortality and health care related factors across European countries

IntroductionDespite the improvements in European health systems, a large number of premature deaths are attributable to treatable mortality. Men make up the majority of these deaths, with a significant gap existing between women and men’s treatable mortality rate in the EU.AimThis study aims to identify the healthcare-related factors, including health expenditures, human and physical resources, and hospital services use associated with treatable mortality in women and men across European countries during the period 2011–2019.MethodsWe use Eurostat data for 28 EU countries in the period 2011–2019. We estimate a panel data linear regression with country fixed effects and quantile linear regression for men and women.ResultsThe results found (i) differences in drivers for male and female treatable mortality, but common drivers hold the same direction for both sexes; (ii) favorable drivers are GDP per capita, health expenditures, number of physicians per capita, and (only for men) the average length of a hospital stay, (iii) unfavorable drivers are nurses and beds per capita, although nurses are not significant for explaining female mortality.ConclusionPolicy recommendations may arise that involve an improvement in hospital bed management and the design of more specific policies aimed at healthcare professionals

Substitutes or complements? Diagnosis and treatment with non-conventional and conventional medicine

Background: Portugal has a strong tradition of conventional western healthcare. So it provides a natural case study for the relationship between Complementary/Alternative Medicine (CAM) and Western Medicine (WM). This work aims to test the relationship between CAM and WM users in the diagnosis and treatment stages and to estimate the determinants of CAM choice. Methods: The forth Portuguese National Health Survey is employed to estimate two single probit models and obtain the correlation between the consumption of CAM and WM medicines in the diagnosis and treatment stages. Results: Firstly, both in the diagnosis and the treatment stage, CAM and WM are seen to be complementary choices for individuals. Secondly, self-medication also shows complementarity with the choice of CAM treatment. Thirdly, education has a non-linear relationship with the choice of CAM. Finally, working status, age, smoking and chronic disease are determinant factors in the decision to use CAM. Conclusion: The results of this work are relevant to health policy-makers and for insurance companies. Patients need freedom of choice and, for the sake of safety and efficacy of treatment, WM and CAM healthcare ought to be provided in a joint and integrated health system

European Health System Typologies: Last 30 Years Under Review

The quest of the researcher to classify national health systems into homogeneous groups has a long history. In this paper, the last 30 years are divided in two periods (1985–2000 and 2000–2015) in order to present and briefly describe the most influential national health system typologies

The Burden of Informal Caregivers of Alzheimer’s Patients: An Estimation to Portugal

The demographic phenomenon of ageing is speeding up in Europe. People live longer and so the prevalence of dementia increases, including Alzheimer’s disease. This is a progressive disease in which people slowly lose their cognitive and physical capacities until death takes over. Alzheimer’s disease not only imposes a very high burden in the affected person but also inflicts a high and overwhelming burden of the caregivers. The carers’ burden includes health deterioration, labour damaging and loses and financial and social costs, while the care provided is not well valued. The aim of this chapter is to review the main trends and concepts related to ageing, caregivers and Alzheimer’s disease. It also presents the economic burden associated with the disease and the monetary value of the care provided by caregivers in Portugal

Universal Health Coverage, Long-Term Care, and Funding in an Aging Era

Universal health coverage has been gaining a wider attention since the beginning of the 2000s, and it has become an ideological reference for health systems across the world. Funding universal health coverage has been a major challenge faced by governments. Not only funding has to be efficient to guarantee people’s access to health services when they are needed, but also it has to ensure equity across people in the country. Aging implies a new constraint to funding as more people contribute less to the collection of financial revenues and more people are in need of healthcare, due to morbidity and end-of-life needs. This chapter aims to present the concept of universal health coverage and LTC and also to discuss how it may be financed under the current scenario of demographic aging and increasing demand for long-term care

Lifestyles, Health, and Life Satisfaction among the Portuguese Seniors

This chapter focuses on the interaction between lifestyles, health, and life satisfaction of Portuguese seniors. The aim of the analysis is to find the main determinants of health and life satisfaction and to verify the importance of lifestyle variables as determinants of health and life satisfaction. We used data collected by the National Health Survey of 2014 and estimated two ordered probits. The main results show that not all lifestyle variables are meaningful in explaining self-assessed health and life satisfaction. The determinants of the health status include education and income; however, it can be assumed that overall good health, family, or close people and income contribute to life satisfaction. A general profile of the Portuguese seniors is provided; however, the results obtained here are changing as a new scenario is emerging, generation X enters old age