Highlights
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- Austerity measures in Portugal involved substantial reforms, including to health care
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- In 2010-2012, unmet medical need doubled in Portugal
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- Health professionals raised concerns regarding increased co-payments and the quality of care
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- Measures are now needed to ameliorate the damage incurred by the recession and austerity.
Abstract
Although
Portugal has been deeply affected by the global financial crisis, the
impact of the recession and subsequent austerity on health and to health
care has attracted relatively little attention. We used several sources
of data including the European Union Statistics for Income and Living
Conditions (EU-SILC) which tracks unmet medical need during the
recession and before and after the Troika's austerity package. Our
results show that the odds of respondents reporting having an unmet
medical need more than doubled between 2010 and 2012 (OR = 2.41, 95% CI
2.01-2.89), with the greatest impact on those in employment, followed by
the unemployed, retired, and other economically inactive groups. The
reasons for not seeking care involved a combination of factors, with a
68% higher odds of citing financial barriers (OR = 1.68, 95% CI
1.32-2.12), more than twice the odds of citing waiting times and
inability to take time off work or family responsibilities (OR 2.18, 95%
CI 1.20-3.98), and a large increase of reporting delaying care in the
hope that the problem would resolve on its own (OR = 13.98, 95% CI
6.51-30.02). Individual-level studies from Portugal also suggest that
co-payments at primary and hospital level are having a negative effect
on the most vulnerable living in disadvantaged areas, and that health
care professionals have concerns about the impact of recession and
subsequent austerity measures on the quality of care provided. The
Portuguese government no longer needs external assistance, but these
findings suggest that measures are now needed to mitigate the damage
incurred by the crisis and austerity.
Keywords
- Austerity;
- Economic crisis;
- Portugal;
- Access to care;
- Co-payments
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