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The study of funding systems is an important issue that can influence the quality of care provided, among other aspects. According to some authors, the structure of any funding system usually involves the definition of the produced quantity and respective prices. It is also claimed that health organizations make their productive structure and their strategic decisions depending on the price system applied.  Currently, the Portuguese funding system is based on the total number of acts and services provided, based on a price basis to be adopted annually by the Ministry of Health. The main production lines defined are inpatient (medical and surgical), ambulatory visits, emergency visits, day hospital, home-care services and continuing care (convalescent and palliative).  Hospitals are grouped according to their characteristics, and there is a price per unit of production defined for each group. The case-mix index (CMI) from the previous year is used to consider the differences among hospitals belonging to the same group.  Additionally, in order to encourage achievement of the activity levels contracted, the contractor may establish rules of remuneration of marginal production (activity above or below the levels fixed by contract).

The funding system and incentives in Portuguese hospitals