Portugal

Healthcare System

Portugal provides universal healthcare to all its residents, including the unemployed and illegal immigrants. There are also health insurance schemes that provide coverage for specific sectors, both public and private. Citizens can also opt for private health insurance schemes. The system providing healthcare in Portugal is called Serviço Nacional de Saúde (SNS), managed by the Ministry of Health, and is mainly funded through general taxation, but a third of its funding comes from the private sector such as out-of-pocket payments via co-funding or direct payment by the patient.

Primary care in Portugal is delivered through a combination of public and private healthcare providers, with the National Health Service (NHS) primarily offering primary and acute general and specialized hospital care. While dental consultations, diagnostic services, renal dialysis, and rehabilitation services are mostly offered by private healthcare providers, these services are often funded by the government under contractual agreements with the NHS. Secondary and tertiary care is mainly provided in hospitals organized into Hospital Centres based on geographical location.

Portugal's main statistical authority is the Instituto Nacional de Estatística (INE), responsible for the production and dissemination of official statistics that ensure the supervision and the technical and scientific coordination of the National Statistical System.

Administrative or Claims Data

Database: Diagnosis Related Groups (GDH)

[1]

Primary purpose: Collect and make available information regarding the use of resources related to inpatient care.

Sponsor, manager or home institution: Serviço Nacional de Saúde (SNS) and Administração Central do Sistema de saúde (ACSS).

Type of information: Hospital code, gender, date of admission, services codes, date of entry into services, date of exit from services, admission diagnosis, main diagnosis, secondary diagnoses, cause of admission, procedures, tumor morphology code, destination after discharge code, birth weight, number of days in preoperative period, type of admission, total days, age, GDH code, major diagnosis category code, date of surgery, transfer reason code, discharge date, area of residence code.

Available type of information:Number of outpatients, equivalent patients, and average delay considering the following variables: Hospitalization, Surgical hospitalization, Medical ICU, Outpatient, Surgical Outpatient, % Outpatient Surgical/Total Scheduled Surgical, and Medical Outpatient.

Source of information: Portugal's hospitals.

Data level: Hospital level (open access) and patient level (restricted access).

Number of Records: Unknown.

Date range: 2011 - 2014 (open access), and 1993 onwards (restricted access).

Cancer Areas of Interest:

Data access: Hospital level information is available here in the documents "National Production by GDH" and "National production by hospital". The document that comprises the periods of 2014 and 2015 does not follow this nomenclature rule and is entitled "2014 GDH APR31". To require access to Patient level data, follow the instructions presented in this website.

Information/contact for data request: Contact information.

Registries

Database: Mortality by Malignant Neoplasms

[2] [3]

Primary purpose: Provide information regarding the national mortality and its social and demographic distribution.

Sponsor, manager or home institution: Instituto Nacional de Estatística (INE).

Type of information: Reference year; Birthplace district; County of fact; Conservatory; Order number; Main cause of death; External cause of death; Mandatory declaration; Date of death; Month of death; Year of death; Location. The cause of death was indicated based on: Sex; Age in days; Age in months; Age in years; Date of birth; Month of birth; Year of birth; Marital status; Nationality; Country of origin; District of residence; County of residence; Parish of residence; Country of residence; Condition before work; Profession; Status in the profession; Field of activity; Wedding month; Wedding year; Spouse's age; Total number of children; Children still alive; Age 0 to 4 years; Age 5 to 9 years; Age 10 to 17 years; Age 18 and over; Affiliation; Mother's date of birth; Mother's birth month; Mother's year of birth; Father's date of birth; Father's birth month; Father's year of birth; Mother's education level; Father's education level; Mother's condition before work; Father's condition before work; Mother's profession; Father's profession; Mother's career status; Father's career status; Mother's field of activity; Father's field of activity; Length of marriage; Mother's age; Father's age; County of birth; Country of birth; Type of death; Type of unnatural death; Instruction of the deceased; Date of wedding; Leading 3-digit cause of death; 3-digit external cause of death; Main cause of death letter; Main cause of death number; External cause of death letter; External cause of death number; Mandatory notifiable diseases; NUTS 1 - 2001; NUTS 2 - 2001; NUTS 3 - 2001; Grand total; N1_new; N2_new; N3_new; NUTS-I 2013; NUTS-II 2013; NUTS-III 2013; Five-year age group up to 95 years; Decennial age group up to 90 years; Age group applied to HIV/AIDS. Total: Age group applied to Alzheimer's; Professions aggregated by CNP 2010; Age ranges of infants; Age of children; Five-year age group up to 85 years; Age in intervals; Chapters; Age groups; Decennial age groups; OECD age groups; Binned age in years.

The list of variables included in Patient level data can be found here. To access the full list of databases in the Health Sector, click here and go to 10. Health > 10.4 Deaths by cause of death > Variable list - Deaths by cause of death - 2020.

Available type of information: Number of deaths filtered by data reference period, region of residence, sex, age group, and death cause (malignant neoplasms).

The following indicators are also available and can be filtered by sex and region of residence:

• Potential years of life lost by type of cancer.
• Rate of potential years of life lost (per 100 000 inhabitants) by type of cancer.
• Mortality rate (per 100 000 inhabitants or in percentage) by type of cancer.
• Standardized mortality rate (per 100 000 inhabitants) by type of cancer.
• Standardized mortality rate (per 100 000 inhabitants) by type of cancer regarding people 65 years of age and older.
• Standardized mortality rate (per 100 000 inhabitants) by type of cancer regarding people younger than 65 years of age.

Source of information: Data collection through the notary offices and registered in the Integrated System for Civil Registration and Identification (SIRIC).

Data level: Regional level (open access) and Patient level (restricted access).

Number of Records: Unknown.

Date range: Regional level (2002 onwards) and Patient level (1998 onwards).

Cancer Areas of Interest: Malignant neoplasm of the lip, base of tongue and other and unspecified parts of tongue, gum, floor of mouth, palate and other and unspecified parts of mouth; Malignant neoplasm of parotid gland and other major and unspecified salivary glands, tonsil, oropharynx, Nasopharyngeal malignant neoplasm; Malignant neoplasm of piriform sinus and hypopharynx; Malignant neoplasm of other locations and ill-defined locations, of the lip, oral cavity and pharynx; Malignant neoplasm of the esophagus, stomach, small intestine, Colon, rectus sigmoid junction, rectum, anus and anal canal; Malignant neoplasm of liver and intrahepatic bile ducts; Malignant neoplasm of gallbladder, other parts, and unspecified parts of biliary tract; Malignant neoplasm of the pancreas; Malignant neoplasm of nasal cavity and middle ear and sinuses, larynx, trachea and bronchi and lungs; Malignant neoplasm of thymus and heart, mediastinum and pleura; Malignant neoplasm of bones and articular cartilages of limbs and bones and articular cartilages of other and unspecified locations; Malignant melanoma of the skin; Other malignant neoplasms of the skin; Mesothelioma; Kaposi's sarcoma; Malignant neoplasm of peripheral nerves and autonomic nervous system and connective and other soft tissues; breast malignant neoplasm; malignant neoplasm of the vulva, vagina, cervix, body of the uterus; Malignant neoplasm of uterus, portion unspecified; malignant neoplasm of ovary; Malignant neoplasm of other and unspecified female genital organs; placental malignant neoplasm; Malignant neoplasm of the penis, prostate, testicles; Malignant neoplasm of other and unspecified male genital organs; Malignant neoplasm of kidney, except renal pelvis; Malignant neoplasm of the renal pelvis, ureters, bladder; Malignant neoplasm of other and unspecified urinary organs; Malignant neoplasm of eye and adnexa; Malignant neoplasm of meninges, brain and spinal cord, cranial nerves and other parts of the central nervous system; Malignant neoplasm of the thyroid gland, adrenal gland; Malignant neoplasm of other endocrine glands and related structures; Hodgkin's disease; Non-Hodgkin's lymphoma, follicular (nodular), Non-Hodgkin's lymphoma, diffuse, Peripheral and cutaneous T-cell lymphomas, Non-Hodgkin's lymphoma of other and unspecified types and other specified types of NK-cellular T-lymphoma; Malignant immunoproliferative diseases; Multiple myeloma and plasma cell malignancies; lymphoid leukemia; myeloid leukemia; Monocytic leukemia, Leukemia of unspecified cell type, Other and unspecified malignant neoplasms of lymphatic, hematopoietic and related tissues and other leukemias of specified cell type; Malignant neoplasm of other digestive organs and ill-defined locations in the digestive tract, other and ill-defined locations of the respiratory tract and intrathoracic organs, soft tissues of the retroperitoneum and peritoneum, other locations and ill-defined locations, and Secondary and unspecified malignant neoplasm of the lymph nodes; Malignant neoplasm, location not specified, secondary and unspecified malignancy of lymph nodes, secondary malignancy of respiratory and digestive organs, secondary malignancy of other locations, and neoplasms of multiple independent locations (primary).

Data access: Regional level data is openly available here. To ask for patient level data, follow the instructions presented in this webpage.

Information/contact for data request: Contact information.

Database: Health Care Personnel Statistics

[4]

Primary purpose: Publish statistics on the number of health professionals registered in the professional organizations.

Sponsor, manager or home institution: Instituto Nacional de Estatística (INE).

Type of information: Number of medical specialists filtered by place of residence, gender and specialty, subspecialty or competence. Considering cancer area, the database presents information about the number of medical and pediatric oncology professionals.

Source of information: Regarding the information about oncologists, the source is the Medical Association.

Data level: Regional level.

Number of Records: Unknown.

Date range: 2011 onwards.

Cancer Areas of Interest: Unknown.

Data access: Open access in this webpage.

Information/contact for data request: Contact information.

Database: Cancer Screening Monitoring

[5]

Primary purpose: Promote the early diagnosis of cancer in order to start treatment early and thus decrease the national cancer mortality rate.

Sponsor, manager or home institution: Direção Geral da Saúde (DGS).

Type of information: Information regarding breast, cervical, colon and rectal cancer screening. Examples of available data are the screening adherence rate, test positivity rate, geographic coverage rate, coverage rate by region, number of eligible population.

Source of information: Forms filled out by the regional Health Administrations and the Autonomous Regions of Portugal.

Data level: Regional level.

Number of Records: Unknown.

Date range: The project occurs since 1990. Regional level data is available 2014 onwards.

Cancer Areas of Interest: Breast, cervical, colon and rectal cancer.

Data access: Regional level data is available here. Monitoring reports are available at the General Health Directorate (DGS) website at the following addresses:

Information/contact for data request: [ Contact information].

Database: Cancer Incidence, Survival and Mortality in the Southern Region of Portugal (ISM)

[6]

Primary purpose: Inform about cancer statistics regarding the south region of Portugal. Gathers information about the following regions: health regions of Lisboa e Vale do Tejo (LVT), Alentejo, Algarve and the Autonomous Region of Madeira.

Sponsor, manager or home institution: National Cancer Registry (RON) and Regional Oncology Registry South (ROR-Sul).

Type of information: Survival (by gender and age) and Incidence rates (specific, crude and standardized for age, sex, and tumor location per 100,000 people) with tables and graphs

Presents also mortality rates (specific, crude and standardized for age, by malignant tumor and sex) information from INE.

Patient level information contains identification fields (example: name, gender, date of birth or age, and address); diagnosis, tumor and treatment fields (diagnosis dates, basis of diagnosis, primary location, histologic type, behavior, stage, treatment start date and treatment sequence); follow-up fields (patient vital status, date and cause of death).

Source of information: Data from public and private health institutions of the region.

Data level: Regional level (open access) and Patient level (restrict acess).

Number of Records: Unknown.

Date range: Regional level is presented from 2002 to 2017, and 1998* - 2000/2001*. Patient level date range is unknown.

(*Only includes cancer incidence data)

Cancer Areas of Interest: The list can be checked at the page 25 of this document.

Data access: Reports with regional data can be accessed through the national miscellaneous publications section on the National Cancer Registry website, at this link.

To access patient level data, it is necessary to fill this document and send to the address presented in it.

Information/contact for data request: Contact information.

Database: Cancer Survival and Incidence in the Northern Region of Portugal

[7] [8]

Primary purpose: Inform about cancer statistics regarding the south region of Portugal. Gathers information about the following districts: Braga, Bragança, Porto, Viana do Castelo and Vila Real.

Sponsor, manager or home institution: National Cancer Registry (RON) and Northern Regional Oncology Registry (RORENO).

Type of information: Cancer survival (overall, observed, net, standardized, by gender, type of tumor, time since diagnosis, age, and region of residence) for people over 15 years old.

Cancer incidence (crude number, crude and standardized rate per 100,000, by sex, age, and tumor location).

Patient level information contains identification fields (example: name, gender, date of birth or age, and address); diagnosis, tumor and treatment fields (diagnosis dates, basis of diagnosis, primary location, histologic type, behavior, stage, treatment start date and treatment sequence); follow-up fields (patient vital status, date and cause of death).

Source of information: Data from public and private health institutions of the region.

Data level: Regional level (open access) and Patient level (restrict acess).

Number of Records: Unknown.

Date range: Incidence is presented from 1988 to 2011. Survival ranges from 2005 to 2010.

Cancer Areas of Interest: Survival - all tumors except basal cellular and squamous cell tumors of the skin. Incidence - all tumors except basal cell carcinomas and nonspecific tumors of the skin.

Data access: Reports with regional data can be accessed through the national miscellaneous publications section on the National Cancer Registry website, at this link.

To access patient level data, it is necessary to fill this document and send to the address presented in it.

Information/contact for data request: Contact information.

Database: Cancer Survival and Incidence in the Central Region of Portugal

[9]

Primary purpose: Inform about cancer statistics regarding the south region of Portugal. Gathers information about the following districts: Aveiro, Castelo Branco, Coimbra, Guarda, Leiria e Viseu.

Sponsor, manager or home institution: National Cancer Registry (RON) and Central zone regional oncology registry (ROR-Centro).

Type of information: Cancer incidence (gross number, gross rate, overall and standardized per 100,000, by sex, age and tumor location).

Patient level information contains identification fields (example: name, gender, date of birth or age, and address); diagnosis, tumor and treatment fields (diagnosis dates, basis of diagnosis, primary location, histologic type, behavior, stage, treatment start date and treatment sequence); follow-up fields (patient vital status, date and cause of death).

Source of information: Data from public and private health institutions of the region.

Data level: Regional level (open access) and Patient level (restrict acess).

Number of Records: Unknown.

Date range: 1989 - 2010.

Cancer Areas of Interest: List is available at the page 3 of this document.

Data access: Reports with regional data can be accessed through the national miscellaneous publications section on the National Cancer Registry website, at this link.

To access patient level data, it is necessary to fill this document and send to the address presented in it.

Information/contact for data request: Contact information.

Database: Cancer Incidence in Portugal

[10]

Primary purpose: Inform about cancer statistics regarding all regions of Portugal.

Sponsor, manager or home institution: National Cancer Registry (RON).

Type of information: Number of new cancer cases by age, sex, tumor site, and place of residence.

Specific, crude and standardized cancer incidence rates per 100,000 persons for age, place of residence, sex and tumor location. Covers the entire territory of Portugal.

Patient level information contains identification fields (example: name, gender, date of birth or age, and address); diagnosis, tumor and treatment fields (diagnosis dates, basis of diagnosis, primary location, histologic type, behavior, stage, treatment start date and treatment sequence); follow-up fields (patient vital status, date and cause of death).

It also presents mortality data by tumor type, age, sex.

Source of information: Data from public and private health institutions in Portugal.

Data level: Regional level (open access) and Patient level (restrict acess).

Number of Records: Unknown.

Date range: 2001 - 2019.

Cancer Areas of Interest:

Data access: Reports with regional data can be accessed through the RON publications section on the National Cancer Registry website, at this link.

To access patient level data, it is necessary to fill this document and send to the address presented in it.

Information/contact for data request: Contact information.

Databases for Clinical Trials, Surveys and Biobanks

Survey: National Health Interview Survey (INS)

[11]

Primary purpose: Publish statistics on health status, health care and health determinants, and socio-demographic characteristics of the population to enable the study and improvement of these areas.

Sponsor, manager or home institution: Instituto Nacional de Estatística (INE).

Type of information: Regarding cancer prevention information, contains the percentage of the female resident population aged 50 to 69 years who reported having had mammography done in the 2 years prior to the interview and the female resident population aged 20 to 69 years who reported having had cervical cytology done in the 3 years prior to the interview, both filtered by education level and region of residence.

The list of variables included in Patient level data is longer and can be checked in this website.

Source of information: Instituto Nacional de Estatística (INE).

Data level: National level (open access) and Patient level (restricted access).

Number of Records: Unknown.

Date range: 2005 onwards. It occurs on a five-year basis.

Cancer Areas of Interest: Breast and cervix neoplasms.

Data access: Mammography examination by education level and region of residence (2005 and 2014 onwards); Cervical cytology by education level and region of residence (2005 and 2014 onwards).

Information/contact for data request: Contact information.