A perceção da equidade e da satisfação no acesso a cuidados na Casa de Saúde São Mateus, SA hospital privado

Abstract

Good health is a social asset. However, in these times of financial and economic uncertainty, it is inevitable that serious issues arise with regard to accessing healthcare; particularly within the private healthcare system for people on low incomes. This raises ethical questions relating to notions of justice and equity. We believe in the importance of adopting policies to promote a National Health System [Sistema Nacional de Saúde] that will provide equitable access to healthcare, creating equal opportunities for all citizens. The constant unpredictability of changes to the healthcare system and reforms in this sector leads to a lack of equality,and puts obstacles in the way of the private health sector, not just in its capacity to respond to economic and financial challenges but also to ethical questions of fair and equitable access for the private and registered people who use the Casa de Saúde S- Mateus – Hospital (CSSM-H) health services. In the 60 years of the CSSM-H’s activities, from 1961 to 2021, fundamental human values, such as is the intrinsic value of human dignity, have always been evident in the day-to-day activities carried out at the Casa de Saúde São Mateus, now Hospital Privado S.A. Bioethics is the foundation for our healthcare activities, with each manager and health professional having a responsibility to be as competent as they should be, and to aim for the highest ethical standards in all their activities. The main objective of our research is to evaluate whether or not equity in accessing treatment – healthcare – exists at CSSM-H., and to understand what constraints are associated with this, as well as the benefits for those who use this health service. It appears that, from the point of view of financial availability, there are indeed constraints. This is why we advocate in our research that the health insurance market and the ADSE itself must increase the services it offers on the national market – with global access – involving companies and individuals in the creation of a health plan which will contribute to a better National Health System (SNS). With greater numbers of people registered, as we propose, equitable access to treatment and healthcare will increase, and the quality of services – both public and private – will improve, insofar as waiting times for general clinical consultations, specialists, diagnostic examinations and surgical interventions will be reduced. According to what we have tried to demonstrate, an increase in registered people will contribute to helping those who are most in need – those people who are not able to acquire health insurance, or who do not have access to the ADSE – as increased use of the private health system will free up the National Health System (SNS), thereby promoting more efficient and effective treatment in the public sector. The more effective and efficient the treatment, the fairer and more equitable it is for the most economically vulnerable sector of society, given that the treatment and care of registered and non-registered people in a private hospital will reduce the pressure on the public hospital, enabling fair treatment and, therefore, greater equity for those people with the greatest need. Our study is an observational, exploratory work, with a cross-sectional approach, which seeks to inquire about the satisfaction and perception of users/clients (protocol and non-protocol) of CSSM-H and identify possible factors that constrain access. equitable treatment and health care. The collection of information to answer the research questions raised was based on the application of a questionnaire prepared by the researcher. This is an original survey.

Date of Award	28 Sept 2023
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Carlos Costa Gomes (Supervisor) & Paulo Pereira (Co-Supervisor)