New models of health services provision in Portuguese health institutions: a performance and quality indicators review & analysis

Background: The expansion of health professionals’ mobility can have effects on planning, regulation and maldistribution of HRH, being associated with a higher professional turn-over, with effects on the performance of the organization. Objective: In this study we aimed to 1) analyse the level to which health organizations in an European country, Portugal, recur to external health professionals and health services provision, as a reflection of the mobility of health professionals between institutions, at local or regional levels, and 2) how that affects health care organizations performance, on dimensions like safety, quality and productivity. Study Design and Setting: Observational, cross-sectional, quantitative study, using secondary data analysis (indicators) from Health Units registered at the Central Health Administration Authority. Multivariate analysis of quantitative data correlation and multiple regression) was performed. Results: Significant Pearson’s correlation was found for costs indicator (percentage of costs), productivity indicator (waiting time for elective surgery), access indicator (waiting time for first consultation), and performance indicator (percentage of day surgery), however no significant correlations for the selected variables were found. Conclusions: Results suggested that there are no changes at performance level, for health institutions due to recurring to external health services and health professionals’ provision and health outcomes. At national level, this practice represents a relevant percentage of the health costs budget, justifying further studies and research on this theme, to allow comparison (benchmarking) with other European countries.