Overview

Portugal has a predominantly tax-based health system with universal coverage. The National Health Service (NHS) co-exists with health subsystems that provide healthcare to specific segments of the population. A comprehensive range of health services are delivered through a mix of public and private contracted providers, with general practitioners (GPs) acting as gatekeepers to specialist and secondary care.  Portugal spent US$ PPP 4464 per person on healthcare in 2022, 62% of which was funded by public sources. Out-of-pocket (OOP) spending in Portugal accounted for 30% of total health expenditure, double the EU average. Most OOP spending went towards cost-sharing for outpatient services and pharmaceuticals.

The organization and governance of the NHS has been a key target of reforms in recent years, along with enhanced accessibility and the targeted strengthening of primary and integrated care. A new NHS Statute passed in 2022 established the NHS Executive Directorate, tasked with management and coordination across the different elements of the NHS. Since 2016 the reform of primary health care has focused on expanding the network of primary care centres both in number and scope. The expansion of the voucher system under the National Programme for Oral Health Promotion in 2021 and the staged abolition of flat-rate charges user charges on a wide range of health services have aimed to improve the accessibility of services.