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Title: Using discrete event simulation to compare the performance of family health unit and primary health care centre organizational models in Portugal
Authors: Fialho, André S.
Oliveira, Mónica D.
Sá, Armando B.
Keywords: Family health units
Primary care reforms
Discrete event simulation
Performance indicators
Issue Date: 2011
Publisher: BioMed Central
Citation: BMC Health Services Research 2011, 11:274
Abstract: Background: Recent reforms in Portugal aimed at strengthening the role of the primary care system, in order to improve the quality of the health care system. Since 2006 new policies aiming to change the organization, incentive structures and funding of the primary health care sector were designed, promoting the evolution of traditional primary health care centres (PHCCs) into a new type of organizational unit - family health units (FHUs). This study aimed to compare performances of PHCC and FHU organizational models and to assess the potential gains from converting PHCCs into FHUs. Methods: Stochastic discrete event simulation models for the two types of organizational models were designed and implemented using Simul8 software. These models were applied to data from nineteen primary care units in three municipalities of the Greater Lisbon area. Results: The conversion of PHCCs into FHUs seems to have the potential to generate substantial improvements in productivity and accessibility, while not having a significant impact on costs. This conversion might entail a 45% reduction in the average number of days required to obtain a medical appointment and a 7% and 9% increase in the average number of medical and nursing consultations, respectively. Conclusions: Reorganization of PHCC into FHUs might increase accessibility of patients to services and efficiency in the provision of primary care services.
Description: © 2011 Fialho et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Peer review: yes
ISSN: 1472-6963
Appears in Collections:FM-IMP-Artigos em Revistas Internacionais

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