Impact of the global financial crisis on newborn care in Portugal and Spain: Perception of health professionals

Abstract

The 2008 global financial crisis had a particularly negative impact on health in Southern European countries, including Portugal and Spain. Official data showed that during 2006‐2014 gross domestic product stagnated or fell in Portugal and Spain and unemployment increased by 3% and 12%, respectively, from 2007 to 2010.1 Both countries needed a European Union bailout and adopted strict fiscal austerity measures, including spending cuts and increased taxes. The impact on healthcare comprised reduced hospital and drug budgets, but the strong effects on perinatal health indicators suggested by previous studies in other contexts were not evident in Portugal and Spain. The birth rate fell in both countries, but maternal, perinatal, neonatal and infant mortality rates were stable or declined. However, there was an overall increase in low birth weight births. As research into the effect of economic downturns on neonatal units is lacking, we aimed to explore its impact on Portuguese and Spanish neonatal units. In 2015, we sent a structured questionnaire to all 98 neonatal units in Portugal and Spain. This covered the general characteristics of the neonatal units, including the level of care and number of beds, the impact of the economic crisis on the functioning of the unit and clinical practice and any consequences for patients. Descriptive statistics are presented as numbers and percentages for categorical variables and medians and interquartile ranges (IQR) for non‐normally distributed continuous variables. Differences between the countries were tested using Pearson's chi‐square or Fisher's exact test. The statistical analysis was performed using STATA 11.2 (StataCorp LLC).