Envelhecimento e saúde em Portugal. Práticas e desafios num cenário de aumento da população idosa. (1974 - 2031)

Abstract

The ageing process in Portugal is evident, and the consequent elderly increase is irrefutable and tendentiously growing. The fact that older people are the health services main users is undeniable. Portuguese economic and financial crisis printed constraints on the national healthcare system and particularly in the National Health Service (NHS). Under this scenario we present two guiding questions to this thesis: (1) In Portugal, healthcare system’s services and human resources, at regional level and essentially in the NHS, are proportional to the number of elderly people, and respond to the needs of current and future elderly population? (2) What adjustments should be promoted in healthcare system’s services and human resources in Portugal, considering the expected increasing of elderly people, of the average life expectancy, the epidemiological profile change, and the changes of profile of the elderly population, in particular regarding to educational level? We argue that the increasing number of elderly in Portugal, with distinct pathologies and delicate socioeconomic and educational profiles, has implications for the healthcare system, particularly for the NHS, for being the elderly who use it the most. In parallel, the increasing number of elderly, consequent from increased life expectancy, emerges from the improvements in the health system, and the creation of the NHS, based on the political centrality of health. In the context the current restrictive policy, resulting of the national economic and financial crisis, regarding the equipment and health human resources, we could verify a detachment of the health services regarding the elderly population, diverging from international political context (the UN, WHO and EU) which provides that health systems should meet the needs of the elderly respecting the accessibility, equity and health surveillance proximity. Subsequently, these limitations may invert the process of increasing life expectancy and result in Portugal incurring in default towards the commitments made to those international organizations. However, on the horizon 2031, with the expected increase in the elderly education level, the orientation of the current policy decision can be well-adjusted to the new profile of this population and can respond to their needs, pursuing the guidelines of UN, WHO and EU. Accordingly, in this thesis, considering the elderly and public health policy in Portugal, we aim: to analyze the response given to the needs of the elderly with its own epidemiological profile in relation to services and human resources for health at the level of NUTS II; and realize their potential suitability, at the horizon 2031, the particularities of the elderly, particularly the development of the indicator level of education.