Patients' satisfaction with the NHS : a novel indicator for Portugal

This paper analyzes the impact of service quality on patients' satisfaction with the Portuguese National Health Service, through a novel indicator the Index of Satisfaction with the NHS that measures the share of children delivered in the NHS hospitals to total number of children delivered, in 2000-2016. We assume that families choose private health institutions if they are not satisfied with the National Health Service. Previous literature relies on questionnaires and surveys about patients' satisfaction, introducing some subjectivity on the analysis since the concept of satisfaction is, itself, debatable, and does not compare the evolution of satisfaction over time. Our study is innovative in this regard. The results indicate that the weaknesses of the Portuguese NHS led public to choose private health institutions. In a context of economic difficulties and the loss of purchasing power, such results have clear implications on the evaluation of the quality of service provided by the NHS in Portugal.