Portuguese Public Hospitals Financial Performance between 2014-2020

Abstract

Background: New challenges must be faced by the Portuguese National Health System, such as ageing population, increase of the burden of multimorbidity and new technologies, in a context of limited financial resources. In this study, we aim to portray hospitals´ financial performance between 2014 and 2020 and describe individual hospitals' behavior based on economic and financial indicators. Methods: Publicly available data from the Central Administration of the Health System and Ministry of Health´s Transparency portal was obtained to analyze the financial performance of Portuguese public hospitals designated as Public Enterprise Entities between 2014 and 2020, based on the descriptive analysis of the following financial indicators: EBITDA, Net Income, Average Payment Period, Operating Margin and Total Debt. Results: Overall EBITDA and Net Income showed a decreasing trend with entities persistently reporting negative values. As for Total Debt and Average Payment Period, it is possible to identify a decreasing trend, especially in those entities reporting greater values in the beginning of the period. Still, other entities did not sustain this decrease and others even show an increasing trend in both values. Conclusion: Overall, financial performance in Portuguese hospitals was poor within the study period with expenses exceeding revenue every year, as reflected in the negative values for EBITDA and Net Income. Sustained structural debt without signs of continuous decrease was also shown by our results. Health managers and authorities responsible for decision making need to adopt new tools and different strategies to prevent these results. Health care provision to population can only be guaranteed with a sustainable health system, in which hospitals play an important role.