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The São João Hospital Center in Porto is able to produce more health care, with shorter waiting times and lower operating costs than the Centro Hospitalar de Lisboa Norte, according to the Court of Auditors. The findings are presented in an audit report by the Court of Auditors, which focused on the management practices of the North Lisbon Hospital Center and the São João Hospital Center in Porto, comparing the management and the results.
According to the report, "if the Centro Hospitalar Lisboa Norte reached a standard patient cost equal to that of the São João Hospital Center, it would have obtained [em 2014-2016] a saving of 211 million euros." This value would be sufficient for the state to finance, for example, three million outpatient consultations or the treatment of 30,000 patients with hepatitis C.
A patient treated at the Lisbon unit was on average 26% more expensive than in São João, but even so, the differences between the two hospitals in terms of costs per patient decreased. Between 2014 and 2016, the São João Hospital Center has lower operating costs and manages to produce more health care with the facilities and equipment it has.
For example, São João produces 35 more TACs per day and 13 resonances than the north of Lisbon. In 2014, 2015 and 2016, he also performed more than 74% of surgeries than the North of Lisbon. Users in São João expect, on average, less time for consultations (less than eight days) and for surgeries (less than 28 days) than those at Centro Hospitalar Lisboa Norte, which integrates Santa Maria and Pulido Valente.
in Lisbon performed better in the waiting times for the general emergency service, even with users less urgent than those in São João. The Court of Auditors points out that the management of the São João Hospital Center relies on management structures, with greater autonomy and with more proactive performance
São João also reveals management information systems that allow for a more rigorous knowledge and at the time of operational costs and a greater knowledge. specifies financing needs [19659002] Regarding the repayment of the debt, in the North Lisbon Hospital Center, the average term "far exceeds 12 months". In São João, "little has passed three months."
The debt of Centro Hospitalar Lisboa Norte increased by nearly seven million per month in 2017, the Court of Accounts considering that she was in technical bankruptcy in 2015 and 2016. According to the report of an audit conducted by the Court of Auditors between December 2016 and November 2017, the debt of the Hospital Center, which integrates Santa Maria and Pulido Valente, increased at a rate of nearly seven million per month "higher than in any other similar period since 2014 ". The document states that "economic and financial recovery efforts" do not achieve the expected results.
The Court of Auditors states that a "substantial part" of the funding granted to Centro Hospitalar Lisboa Norte "had no counterpart in health care," serving to finance "inefficiencies" and to deal with "the continued growth of the debt of the suppliers." In a contradictory opinion, the chairman of the board of directors of Centro Hospitalar Lisboa Norte informed the Court of Auditors that in March this year, the value of the debt "was reduced due to the capital increase", hoping that in the second half
Nevertheless, the Court of Auditors states that "debts to suppliers are an unresolved problem at the Centro Hospitalar Lisboa Norte "and considers that regardless of The pace of debt growth last year shows that the payment of outstanding debt will not solve the problem of the need to contain the rise in the value of the "
The Court of Auditors had already advised that there is a" marked structural imbalance "in the Centro Hospitalar Lisboa Norte, which has been covered by capital increases by the State. but who have no direct counterpart in the provision of care. The Court of Audit understands that the Lisboa Norte Hospital Center "has highlighted a debt structure totally dependent on the funds of others", which puts it "in technical bankruptcy". There is also a "clear underutilization of equipment" in this hospital, one of the largest in the country.
This Audit of the Court of Accounts was oriented towards the management practices of the Hospital Center of North Lisbon and the Hospital Center of São João in Porto. , by comparing the management structures and the results obtained. With regard to São João, it is mentioned that this hospital experienced a "deterioration" of solvency between 2014 and 2016, but it has sufficient funds to cover the credits obtained.
By comparing the two structures, the Court states that "if Centro Hospitalar Lisboa Norte reached a standard patient cost equal to that of the Hospital Center of São João, it would have obtained [em 2014-2016] a saving of 211 million. euros. "This would be enough for the state to fund, for example, three million outpatient consultations or the treatment of 30,000 patients with hepatitis C.
The Court of Audit recommends that the government provide adequate funding for the needs of hospitals and hospitals to reduce the accumulation of debts of healthcare institutions.The report of the Court of Auditors recommends that the Ministers of Health and Finance adjust the funding levels to the needs hospitals, in order to break the expectations of the boards of directors concerning extraordinary and cyclical financing "
These reinforcements, according to the Court of Auditors, were made by capital endowment or reinforcement of funds intended paying debts to suppliers and "did not contribute to reducing the debt trend of the National Health Service". mptes states that the reinforcement of the funds intended to pay the debts did not serve to reduce the debt nor the balance of the accounts of the hospitals, "in particular of the Hospital Center of Lisbon", which consists of Santa Maria and Pulido Valente hospitals.
The report recommends that the government provide "clear and effective guidelines to contain the repeated practices of SNS activity financing … by accumulating debt to suppliers". Objective objectives should be set to reduce the amounts and average duration of payments, especially for the North Lisbon Hospital Center.
The Court also considers that there should be more transparent criteria for the allocation of extraordinary funds to hospitals, noting that the Lisbon Norte Hospital Center received funding in 2014, 2015, and 2016 23 % higher than the one awarded to the São João Hospital Center.
Still, according to the report, São João's performance is more favorable in most of the indicators analyzed. São João presented lower operating costs (minus 211 million euros, adjusted for standard patients, between 2014 and 2016), managing to produce "more health care with facilities and equipment at his disposal. "
