title: Primary healthcare in Portugal: 10 years of contractualization of health services in the region of Lisbon.
abstract: Contractualization consists in the development and implementation of a documented agreement whereby one party (payer) provides compensation to the other party (provider) in exchange for a set of health services to a targeted population. We describe, through a case study, the history and the process of implementation of primary health care contractualization (since 1992) in Portugal, emphasizing the consolidation and future challenges of the primary healthcare reform started in 2005. This article resorts to a case study to reflect on the results obtained in the Cluster of Health Centers of the Northern West, Regional Administration of Lisbon and Tagus Valley, between 2009 and 2015, following implementation of contractualization. It was found that the incentive-related payments will have to be weighted considering the results obtained, strongly influenced by epidemiological and socioeconomic change.
authors.affiliation: Gabinete de Auditoria Interna, Administração Regional de Saúde de Lisboa e Vale do Tejo. Av. Estados Unidos da América 77. 1749-096 Lisboa Portugal. ricardo.monteiro.baltazar@gmail.com.
authors.forename: Baltazar Ricardo
authors.initials: BR
authors.lastname: Monteiro
authors.affiliation: Diretora Executiva do ACeS Oeste Norte, Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa Portugal.
authors.forename: Ana Maria Silva Azenha
authors.initials: AM
authors.lastname: Pisco
authors.affiliation: Núcleo de Estudos e Planeamento, Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa Portugal.
authors.forename: Fátima
authors.initials: F
authors.lastname: Candoso
authors.affiliation: Departamento de Planeamento e Contratualização, Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa Portugal.
authors.forename: Sónia
authors.initials: S
authors.lastname: Bastos
authors.affiliation: Departamento de Planeamento e Contratualização, Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa Portugal.
authors.forename: Magda
authors.initials: M
authors.lastname: Reis
mesh_terms: D032982:Contracts; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration* / Q000639:trends; D018166:Health Care Reform; D006296:Health Services / Q000639:trends; D006301:Health Services Needs and Demand; D006801:Humans; D011174:Portugal; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration* / Q000639:trends