A services delivery perspective to the provision of long-term care in Portugal


  • Juan E Tello, WHO Regional Office for Europe
  • Hector Pardo-Hernandez, WHO Regional Office for Europe
  • Manfred Huber, WHO Regional Office for Europe
  • Isabel Yordi Aguirre, WHO Regional Office for Europe
  • Erica Barbazza, Amsterdam UMC, Department of Public Health, University of Amsterdam




Tello, J.E., Pardo-Hernandez, H., Rodrigues, R., Ilinca, S., Leichsenring, K., Huber, M., Yordi Aguirre, I. & Barbazza, E. (2020). A services delivery perspective to the provision of long-term care in Portugal. Public Policy Portuguese Journal, 5(1), 8-25.


Integrated care is of particular relevance to the delivery of long-term care services for older people in order to optimally respond to their often highly diversified health and social care needs. This study set out to develop a comprehensive overview of long-term care in Portugal from a services delivery perspective that dually captures health and social services. Information was consolidated from a wide range of sources including international databases, scientific and grey literature, facility visits, semi-structured group interviews and roundtable discussions with key stakeholders. The findings report the burden of chronic, noncommunicable diseases and disabilities facing Portugal’s older population, in particular women. The current model of care is explored by analyzing available health and social services for older people, care pathways, needs assessment protocols, organization of providers, management and improvement of services, together with system arrangements for governing, financing and resourcing. The findings signal the need to reorient the model of care towards a person-centred approach and to link-up health and social services around unified needs assessments, explicit entitlement of care and beneficiary pathways and common quality and performance assessment mechanisms. This study has important policy relevance for Portugal’s continued development of long-term care services.

Stefania Ilinca and Ricardo Rodrigues contributed to this study by intensive desk research and fact-finding during a mission to Portugal,  Kai Leichsenring contributed to the conceptual framework together with colleagues from WHO Europe who guided, edited and finalised drafts and results. 


Peer reviewed articles