National Health Plan 2012-2016 Summarised Version (May 2013) National Health Plan 2012-2016 TABLE OF CONTENTS CONTENTS OF BOXES, FIGURES AND TABLES ........................................................................................ 4 TECHNICAL INFORMATION .................................................................................................................... 5 RECEIVED CONTRIBUTIONS ................................................................................................................... 9 ABBREVIATIONS AND ACRONYMS ...................................................................................................... 14 EXPLANATORY NOTE ........................................................................................................................... 17 PREFACE BY THE MINISTRY OF HEALTH .............................................................................................. 18 MESSAGE FROM THE DIRECTOR-GENERAL OF HEALTH ...................................................................... 20 1. FRAMEWORK OF THE NATIONAL HEALTH PLAN ............................................................................ 22 1.1. Foreword ................................................................................................................................... 22 1.2. Vision of the NHP ...................................................................................................................... 23 1.3. Mission of the NHP ................................................................................................................... 23 1.4. Construction Process of the NHP .............................................................................................. 24 1.5. Values and Principles of the NHP .............................................................................................. 25 1.6. Conceptual Model and Structure .............................................................................................. 25 2. PORTUGUESE HEALTH PROFILE ....................................................................................................... 29 2.1. Health Status of the Population ................................................................................................ 29 2.1.1. Health determinants ............................................................................................................ 29 2.1.2. Health status ........................................................................................................................ 31 2.2. Organisation of Resources, Provision of Healthcare and Funding ............................................ 34 2.2.1. Structure .............................................................................................................................. 34 2.2.2. Funding and expenditure ..................................................................................................... 35 3. STRATEGIC AXES .............................................................................................................................. 37 3.1. Citizenship in Health ................................................................................................................. 37 3.1.1. Concepts .............................................................................................................................. 37 3.1.2. Guidelines and evidence ...................................................................................................... 38 3.1.3. Vision for 2016 ..................................................................................................................... 40 Page 1/114 3.2. Equity and Access to Healthcare ............................................................................................... 42 3.2.1. Concepts .............................................................................................................................. 42 3.2.2. Guidelines and evidence ...................................................................................................... 43 3.2.3. Vision for 2016 ..................................................................................................................... 45 3.3. Quality in Health ....................................................................................................................... 47 3.3.1. Concepts .............................................................................................................................. 47 3.3.2. Guidelines and evidence ...................................................................................................... 48 3.3.3. Vision for 2016 ..................................................................................................................... 50 3.4. Healthy Policies ......................................................................................................................... 52 3.4.1. Concepts .............................................................................................................................. 52 3.4.2. Guidelines and evidence ...................................................................................................... 54 3.4.3. Vision for 2016 ..................................................................................................................... 56 4. GOALS FOR THE HEALTH SYSTEM .................................................................................................... 58 4.1. Obtaining Health Gains ............................................................................................................. 58 4.1.1. Concepts .............................................................................................................................. 58 4.1.2. Guidelines and evidence ...................................................................................................... 61 4.1.3. Vision for 2016 ..................................................................................................................... 62 4.2. Promoting Supportive Environments for Health Over the Life Cycle ....................................... 63 4.2.1. Concepts .............................................................................................................................. 63 4.2.2. Guidelines and evidence ...................................................................................................... 65 4.2.3. Vision for 2016 ..................................................................................................................... 67 4.3. Strengthening Economic and Social Support in Health and Disease ........................................ 69 4.3.1. Concepts .............................................................................................................................. 69 4.3.2. Guidelines and evidence ...................................................................................................... 71 4.3.3. Vision for 2016 ..................................................................................................................... 73 4.4. Strengthening Portugal's Participation in Global Health .......................................................... 74 4.4.1. Concepts .............................................................................................................................. 74 4.4.2. Guidelines and evidence ...................................................................................................... 75 4.4.3. Vision for 2016 ..................................................................................................................... 77 Page 2/114 6. HEALTHCARE INDICATORS AND TARGETS ....................................................................................... 79 6.1. Concepts .................................................................................................................................... 79 6.2. Indicators of the National Health Plan 2012-2016.................................................................... 82 6.2.1. Proposed Indicators ............................................................................................................. 82 6.2.2. Indicators to be Developed .................................................................................................. 84 7. GENERAL BIBLIOGRAPHY ................................................................................................................. 87 8. ANNEX ........................................................................................................................................... 111 Page 3/114 CONTENTS OF BOXES, FIGURES AND TABLES Box 1 – WHO Evaluation of the NHP 2004-2010 ................................................................................................. 24 Box 2 – Values and principles of the NHP 2012-2016 ......................................................................................... 25 Box 3 – Dimensions of the Conceptual Model .................................................................................................... 25 Box 4 – Cross-sectional policies and healthcare provision for the strategic implementation of the NHP ......... 28 Box 5 – Health inequalities .................................................................................................................................. 42 Box 6 – Adequate access results from several interrelated dimensions ............................................................