Decentralization and privatization in Portuguese health reforms

ABSTRACT - The Portuguese National Health Service (SNS), a universal, centralized and public owned health care system, exhibits an extraordinary record of equalization in the access to health care and health gains in the late thirty years. However, the most recent history of the Portuguese health reform is pervaded by the influence of decentralization and privatization. Decentralization has been present in the system design since the 1976 Constitution, at least in theory. Private ownership of health care suppliers and out-ofpocket expenditures, on the financing side, both have a long tradition of relevance in the NHS mix of services. The initial aim of this study was to demonstrate expected parallelism between health reforms and public administration reforms, where a common pattern of joint decentralization and privatization was observed in many countries. Observers would be tempted to consider these two movements as common signs of new public management (NPM) developments. They have common objectives, are established around the core concepts of gains in effectiveness, efficiency, equity and quality of public services, through improved accountability. However, in practice, in Portugal, each movement was developed in a totally separated way. Besides those rooted in the NPM theory, there are few visible signs of association between decentralization and privatization. Decentralization, in the Portuguese SNS, was never intended to be followed by a privatization movement; it was seen merely as a public administration tool. Private management of health services, as stated in the most recent SNS legislation, was never intended to have decentralization as a condition or as a consequence. Paradoxically, in the Portuguese context, it has led invariably to centralized control. While presented as separate instruments for a common purpose, the association between decentralization and privatization still lacks a convincing demonstration. Many common health care management stereotypes remain to be checked out if we want to look for eventual associations between these two organizational tools.

An object-oriented model for rapid prototyping of data path/control systems - a case study

Publicado em "Information control in manufacturing 1998 : (INCOM'98) : advances in industrial engineering : a proceedings volume from the 9th IFAC Symposium, Nancy-Metz, France, 24-26 June 1998. Vol. 2"

Object-oriented inheritance of statecharts for control applications

This paper discusses how object-oriented iuheritance can be re-interpreted if statecharts are used for modelling the dynamic behaviour of an object. The support of inheritance of statecharts allows the improvement of systems' development by easing the reutilization of parts of already developed euccessful systems, aad by promoting the iterative and continuous models' refinement advocated by the operatioaal approach. Statechart is the formalism used within UML to specify reactive state.based behaviours. This paper covers the use of statecharts within the modelling of embedded systems for industrial control applxications, where performance and memory usage are main concerns.

Digital gesteuerte Stromquellen für das Lichtbogenschweißen

Digital control, power source, arc welding, process control, information management, transient behaviour, thermal impedance, simulation, duty cycle, system design

Relay-assisted transmission and radio resource management for wireless networks

The following paper presents an overview of the Ph.D Thesis1 presented in [1], which compiles all the research done during the period of time between 2004-2007. In that dissertation the relay-assisted transmission with half-duplex relays is analyzed from different points of view. This study is motivated by the necessity of finding innovative solutions to cope with the requirements of next generation wireless services, and with current radio technology. The use of relayed communications represents a change of paradigm of conventional communications, and requires the definition and evaluation of protocols to be applied to single or multiple-user relay communication. With the two fold goal of enhancing spectral efficiency and homogenize service in cellular communications, system design is investigated at physical (type of transmissions of the relay, decoding mode, ..) and upper layers (resource allocation, dynamic link control).

Organizational configurations of strategic choices and strategic management accounting

This is the first study to adopt a configurational paradigm in an investigation of strategic management accounting (SMA) adoption. The study examines the alignment and effectiveness of strategic choice and strategic management accounting (SMA) system design configurations. Six configurations were derived empirically by deploying a cluster analysis of data collected from a sample of 193 large Slovenian companies. The first four clusters appear to provide some support for the central configurational proposition that higher levels of vertical and horizontal configurational alignments are associated with higher levels of performance. Evidence that contradicts the theory is also apparent, however, as the remaining two clusters exhibit high degrees of SMA vertical and horizontal alignment, but low performance levels. A particular contribution of the paper concerns its demonstration of the way that the configurational paradigm can be operationalised to examine management accounting phenomena and the nature of management accounting insights that can derive from applying the approach.

Projecte FacturaCloud, sistema de facturació al núvol

FacturaCloud és un disseny de un sistema de facturació al núvol.

Usabilidad de PDA's

Anàlisi dels PDA, des del punt de vista de la facilitat d'ús i el disseny centrat en l'usuari, per comprovar fins a quin punt es té en compte aquesta expansió.

Gestió de comandes d'un restaurant amb .NET

El projecte Gestió de comandes d'un restaurant amb .NET consisteix en el disseny i implementació d'una solució integral per a gestionar el negoci d'un restaurant de forma completa.

Gestió de devolucions de material

El projecte vol donar una solució integral que cobreixi el circuit prèviament descrit i permeti la consecució eficient del mateix des dels punts de vista del client i del personal intern.

Redefinición del interfaz del Centro de Tráfico Centralizado (CTC) de una explotación ferroviaria

En aquest projecte, es mira de reflectir la necessitat d'utilitzar l'enginyeria i la facilitat d'ús per millorar els sistemes de control en temps real que es fan servir avui dia per a controlar processos crítics.

Comerç Electrònic amb J2EE

Aquest treball crea el disseny d'una infraestructura per a desenvolupar aplicacions de comerç electrònic amb tecnologia J2EE i presenta una implementació específica com a demostració de la seva viabilitat.

Aplicació J2EE per la Gestió de Carteres i Anàlisis Tècnic de Valors Bursátils

Aquest TFC parteix de la necessitat de desenvolupar una aplicació web que presenti la característica de ser escalable, robusta i reutilitzable, dins del paradigma de la orientació a objectes i que permeti una estructura distribuïda, tant de components com de sistemes d'informació.

Aplicació Web per la gestió del personal portuari

Aquest treball crea una aplicació web per a la gestió del personal portuari de Barcelona.

Anàlisis, disseny i implementació d'una aplicació de gestió d'històries mèdiques per un sistema multi centres mitjançant tecnologia J2EE, i tecnologia de xarxes de bases de dades

El treball final de carrera 'HISMED', es basa en l'anàlisi, disseny, investigació e implementació d'una aplicació dins l'àmbit assistencial sanitari amb la premissa de voler ser un sistema per oferir un servei sanitari de millor qualitat, i crear un entorn en el qual investigadors, laboratoris, metges i personal docent comparteixen dades amb una rellevància cabdal per les seves professions. Oferint-los una eina de consulta molt potent en quant a l'obtenció de dades clíniques, que els permet explotar la informació segons convingui el cas.