This report reviews the quality of health care in Portugal, seeks to highlight best practices, and provides a series of targeted assessments and recommendations for further improvements to quality of care.

This report reviews the quality of health care in Portugal, seeks to highlight best practices, and provides a series of targeted assessments and recommendations for further improvements to quality of care. The Portuguese National Health Service has responded well to financial pressure, successfully balancing the twin priorities of financial consolidation and continuous quality improvement. Even in the post-crisis years when GDP fell and health spending declined, improvements in quality of care continued. The need to reduce health spending has been met through a combination of structural reforms, and a well-designed suite of quality initiatives. Reforms around the purchasing and use of pharmaceuticals and medical devices have helped drive down costs, and Portugal has been innovative in how public funds are used to pay providers, increasingly basing payments on quality and efficiency. Important priorities for further work in the Portuguese health system do remain. Portugal will need to improve clinical processes and pathways, particularly in the acute sector. There is still room to improve efficiency, for instance increasing the share of generic drug consumption, and using the Portuguese health workforce more effectively, especially through expanded roles for nurses. Further structural reform is needed with an emphasis on shifting care out of hospitals into less-expensive community settings, and Portugal will also need to reflect on the strategic direction of the primary care system which, following an impressive reform, now risks developing into a two-tiered system with increasingly divergent levels of care quality.

This report reviews the quality of health care in Japan, and seeks to highlight best practices, and provides a series of targeted assessments and recommendations for further improvements to quality of care.

Australia’s health system functions remarkably well, despite operating under a complex set of institutions that make coordinating patient care difficult. Australia should adopt a national approach through an enhanced federal government role in steering policy, funding and priority setting.

This book summarises the main challenges and good practices to support improvements in health care quality, and to help ensure that the substantial resources devoted to health are being used effectively in supporting people to live healthier lives.